Illicit drug use, depression and their association with highly active antiretroviral therapy in HIV-positive women.
BACKGROUND
We examined the interaction of illicit drug use and depressive symptoms, and how they affect the subsequent likelihood of highly active antiretroviral therapy (HAART) use among women with HIV/AIDS.


METHODS
Subjects included 1710 HIV-positive women recruited from six sites in the U.S. including Brooklyn, Bronx, Chicago, Los Angeles, San Francisco/Bay Area, and Washington, DC. Cases of probable depression were identified using depressive symptom scores on the Center for Epidemiologic Studies Depression Scale. Crack, cocaine, heroin, and amphetamine use were self-reported at 6-month time intervals. We conducted multivariate random logistic regression analysis of data collected during 16 waves of semiannual interviews conducted from April 1996 through March 2004.


RESULTS
We found an interaction effect between illicit drug use and depression that acted to suppress subsequent HAART use, controlling for virologic and immunologic indicators, socio-demographic variables, time, and study site.


CONCLUSIONS
This is the first study to document the interactive effects of drug use and depressive symptoms on reduced likelihood of HAART use in a national cohort of women. Since evidence-based behavioral health and antiretroviral therapies for each of these three conditions are now available, comprehensive HIV treatment is an achievable public health goal.
Cook
Judith A
JA
Center on Mental Health Services Research and Policy, Department of Psychiatry M/C 912, University of Illinois at Chicago, 1601 W. Taylor Street M/C 912, Chicago, IL 60612, USA. cook@ripco.com
Grey
Dennis D
DD
Burke-Miller
Jane K
JK
Cohen
Mardge H
MH
Vlahov
David
D
Kapadia
Farzana
F
Wilson
Tracey E
TE
Cook
Robert
R
Schwartz
Rebecca M
RM
Golub
Elizabeth T
ET
Anastos
Kathryn
K
Ponath
Claudia
C
Goparaju
Lakshmi
L
Levine
Alexandra M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D013287:Illicit Drugs; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data
D013287:Illicit Drugs