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A Closer Look at Depression and Its Relationship to HIV Antiretroviral Adherence

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Depression consistently predicts nonadherence to human immunodeficiency virus antiretroviral therapy, but which aspects of depression are most influential are unknown. Such knowledge could inform assessments of adherence readiness and the type of depression treatment to utilize.

Purpose

We examined how depression severity, symptom type, and change over time relate to adherence.

Methods

Microelectronic adherence and self-reported depression data from 1,374 participants across merged studies were examined with cross-sectional and longitudinal analyses. Depression variables included a continuous measure, categorical measure of severity, cognitive and vegetative subscales, and individual symptoms.

Results

At baseline, mean adherence was 69%, and 25% had mild/moderate and 18% had severe depression. In cross-sectional multivariate analyses, continuous depression, cognitive depressive symptoms, and severe depression were associated with lower adherence. In longitudinal analysis, reductions in both continuous and categorical depression predicted increased adherence.

Conclusions

The relationship between global continuous depression and nonadherence was statistically significant, but relatively weak compared to that of cognitive depressive symptoms and severe depression, which appear to pose strong challenges to adherence and call for the need for early detection and treatment of depression.

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Acknowledgments

This research was supported by the Multi-site Adherence Collaboration in HIV (MACH14) grant R01MH078773 from the National Institute of Mental Health (NIMH), Office on AIDS. The original grants of individual participating studies are: R01DA11869, R01MH54907, R01NR04749, R01NR04749, R01MH68197, R01DA13826, K23MH01862, R01MH01584, R01AI41413, R01 MH61173, NIH/NIAID AI38858, AI069419, K02DA017277, R01DA15215, NIMH P01MH49548, R01MH58986, R01MH61695, CC99-SD003, CC02-SD-003 and R01DA015679. We would like to thank all the patients who participated in each of the individual studies. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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The authors have no conflict of interest to disclose.

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Correspondence to Glenn J. Wagner Ph.D..

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Wagner, G.J., Goggin, K., Remien, R.H. et al. A Closer Look at Depression and Its Relationship to HIV Antiretroviral Adherence. ann. behav. med. 42, 352–360 (2011). https://doi.org/10.1007/s12160-011-9295-8

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