Psychopathology in male and female HIV-positive and negative injecting drug users: longitudinal course over 3 years.
OBJECTIVE
To evaluate the impact of HIV illness on psychiatric and psychosocial functioning over 3 years in a sample of male and female HIV-positive injecting drug users (IDU), with a comparison group of HIV-negative male and female IDU.


METHODS
As part of a multidisciplinary study, 121 men (69 HIV-positive, 52 HIV-negative) and 66 women (36 HIV-positive, 30 HIV-negative) were evaluated semiannually for seven visits. Attrition, unrelated to sex or serostatus, was 33%.


RESULTS
At baseline, rates of major depression and dysthymia ranged from 15% (HIV-negative men) to 33% (HIV-positive men and HIV-negative women). Global impairment was in the range found in psychiatric patients (mean Global Assessment of Functioning scores, 46-51). Higher levels of social support and less social conflict were independently associated with decreased distress and improved global functioning among both men and women. For both HIV-positive groups, degree of improvement over time was related to degree to HIV progression: those who remained healthier in terms of CD4 count and illness stage showed more improvement. HIV-seronegative status was associated with less distress for men but not for women. Overall, women reported higher levels of psychiatric distress than men.


CONCLUSIONS
High rates of psychopathology were found in this IDU cohort, independent of HIV status and sex. Although rates of psychopathology, injecting drug use and distress declined slightly during the study, they remained elevated; accordingly, psychiatric services are indicated for this population.
Rabkin
J G
JG
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Johnson
J
J
Lin
S H
SH
Lipsitz
J D
JD
Remien
R H
RH
Williams
J B
JB
Gorman
J M
JM
D015331:Cohort Studies; D003220:Conflict, Psychological; D003863:Depression; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012931:Social Environment; D012944:Social Support; D015819:Substance Abuse, Intravenous; D013997:Time Factors