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Depressive Symptoms and Antiretroviral Therapy (ART) Initiation Among HIV-Infected Russian Drinkers

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Abstract

The impact of depressive symptoms on ART initiation among Russian HIV-infected heavy drinkers enrolled in a secondary HIV prevention trial (HERMITAGE) was examined. We assessed 133 participants eligible for ART initiation (i.e., CD4 count <350 cells/μl) who were not on ART at baseline. Depressive symptom severity and ART use were measured at baseline, 6- and 12-months. Association between depressive symptoms and subsequent ART initiation was evaluated using GEE logistic regression adjusting for gender, past ART use, injection drug use and heavy drinking. Depressive symptom severity was not significantly associated with lower odds of initiating ART. Cognitive depression symptoms were not statistically significant (global p = 0.05); however, those with the highest level of severity had an AOR of 0.25 (95 % CI 0.09–0.71) for delayed ART initiation. Although the effect of depression severity was not significant, findings suggest a potential role of cognitive depression symptoms in decisions to initiate ART in this population.

Resumen

En este artículo se examina el impacto de síntomas depresivos en la decisión de bebedores de riesgo, infectados con VIH, para iniciar el TARV. Ellos fueron inscritos en un estudio en Rusia diseñado para prevenir el contagio del VIH en otras personas (HERMITAGE). Evaluamos a 133 participantes elegibles para comenzar el tratamiento TARV (i.e., recuento de CD4 < 350 células/μl) quienes no estaban en TARV al inicio del estudio. La severidad de los síntomas depresivos y el uso de TARV fueron medidos a 0, 6 y 12 meses. La asociación entre síntomas depresivos y la subsecuente iniciación de TARV fue evaluada usando regresión logística GEE ajustada por género, antiguo uso del TARV, uso de drogas inyectadas y uso de alcohol en exceso. La severidad de síntomas depresivos no está significativamente asociada con menores probabilidades de comenzar TARV. Síntomas de depresión cognitiva no fueron estadísticamente significantes (global p = 0.05); sin embargo, aquellos con mayor nivel de severidad tenían un ORA de 0.25 (95 % IC 0.09-0.71) en el retraso para iniciar TARV. Aunque los efectos de la severidad de la depresión no fueron significantes, los resultados sugieren un rol potencial de los síntomas de la depresión cognitiva en las decisiones para iniciar TARV en esta población.

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Acknowledgments

The study was supported by the National Institute on Alcohol Abuse and Alcoholism: R01AA016059, U24AA020778, U24AA020779, and K24AA15674. We appreciate the editorial assistance of Marlene C. Lira and translation service of Laura Wulach in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Psychology, Boston University, 648 Beacon Street, 4th Floor, Boston, MA, 02215, USA

    Tracie M. Goodness & Tibor P. Palfai

  2. Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA

    Debbie M. Cheng, Carly Bridden & Jeffrey H. Samet

  3. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Debbie M. Cheng

  4. Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA

    Sharon M. Coleman

  5. Laboratory of Clinical Pharmacology of Addictions, First St. Petersburg Pavlov State Medical University, St. Petersburg, Russia

    Elena Blokhina & Evgeny Krupitsky

  6. Department of Addictions, Bekhterev Research Psychoneurological Institute, St. Petersburg, Russia

    Evgeny Krupitsky

  7. Department of Community Health Services, Boston University School of Public Health, Boston, MA, USA

    Jeffrey H. Samet

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  1. Tracie M. Goodness
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Correspondence to Tracie M. Goodness.

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Goodness, T.M., Palfai, T.P., Cheng, D.M. et al. Depressive Symptoms and Antiretroviral Therapy (ART) Initiation Among HIV-Infected Russian Drinkers. AIDS Behav 18, 1085–1093 (2014). https://doi.org/10.1007/s10461-013-0674-y

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