title: Depressive symptoms, quality of life, and neuropsychological performance in HIV/AIDS: the impact of gender and injection drug use.
abstract: Limited attention has been paid to the potential impact of gender and injection drug use (IDU) on mood, quality of life, and neuropsychological performance in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Several studies that describe the natural history of HIV/AIDS in terms of mental health and neuropsychological ability have focused solely on men or have excluded injection drug users. Women and injection drug users are two groups for whom the incidence of HIV infection is increasing. Additionally, the National Academy of Sciences recently recommended that studies concerned with health-related research include males and females, and that researchers analyze their data for gender differences. The goals of the current study were to investigate possible relationships between HIV and IDU status and depressive symptoms, quality of life, and neuropsychological performance in women and men matched for age, race, and education. Overall, women reported more depressive symptoms than men, and this gender difference was most evident in women who were both infected with HIV and who were also injection drug users. Women and HIV-infected individuals reported the poorest quality of life scores. Women outperformed men on a measure of verbal memory and HIV(-) participants outperformed HIV(+) participants on a measure of perceptual speed. Finally, gender and HIV status interacted such that uninfected women performed the best, and infected men performed the worst, on a test of verbal memory. A better understanding of how men and women with different drug use profiles respond to HIV/AIDS may substantially improve survival, as well as aspects of daily functioning, of affected individuals. Thus, further study and development of treatment protocols targeted at including women and IDU are needed.
authors.affiliation: Department of Pediatrics, The Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA. amy.wisniewski@drake.edu
authors.forename: Amy B
authors.initials: AB
authors.lastname: Wisniewski
authors.forename: Samantha
authors.initials: S
authors.lastname: Apel
authors.forename: Ola A
authors.initials: OA
authors.lastname: Selnes
authors.forename: Avindra
authors.initials: A
authors.lastname: Nath
authors.forename: Justin C
authors.initials: JC
authors.lastname: McArthur
authors.forename: Adrian S
authors.initials: AS
authors.lastname: Dobs
mesh_terms: D000328:Adult; D000339:Affect; D003042:Cocaine; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000473:pathology; D004493:Education; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D006306:Health Surveys; D003932:Heroin; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D011788:Quality of Life; D012737:Sex Factors; D015819:Substance Abuse, Intravenous
chemical_list: D003932:Heroin; D003042:Cocaine