Effects of depressive symptoms and mental health quality of life on use of highly active antiretroviral therapy among HIV-seropositive women.
This study examines the effects of depressive symptoms and mental health quality of life on utilization of highly active antiretroviral therapy (HAART) among HIV-seropositive women. Data were collected biannually from 1996 through 1998 in a prospective cohort study. Women reported use of antiretroviral therapy, health and mental health status, demographics, and social and behavioral factors; CD4 count and viral load also were assessed. Random effects regression models estimated the longitudinal effects of depressive symptoms and mental health quality of life on the probability of HAART utilization, controlling for clinical indicators (CD4 count, viral load, symptom presence), demographics (race, age, education), behavioral factors (drug/alcohol use, clinical trials participation), service features (insurance status, mental health service utilization), and study site. High levels of depressive symptoms and poor mental health quality of life were found, and they significantly reduced the probability of HAART utilization. Receiving mental health services significantly increased the probability of utilizing HAART. HIV-seropositive women characterized as being in poor mental health were less likely to use HAART, whereas those receiving treatment of mental health difficulties were more likely to use HAART. These findings suggest that efforts to enhance women's access to psychological treatment may increase their use of the latest HIV therapies.
Cook
Judith A
JA
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois 60603, USA. cook@ripco.com
Cohen
Mardge H
MH
Burke
Jane
J
Grey
Dennis
D
Anastos
Kathryn
K
Kirstein
Lynn
L
Palacio
Herminia
H
Richardson
Jean
J
Wilson
Tracey
T
Young
Mary
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000628:therapy; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000523:psychology*; D006297:Health Services Accessibility; D006801:Humans; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D014481:United States