title: Incident depression symptoms are associated with poorer HAART adherence: a longitudinal analysis from the Nutrition for Healthy Living study.
abstract: OBJECTIVE
  To determine the relationship between incident depression symptoms and suboptimal adherence to HIV highly active antiretroviral therapy (HAART).
  
  
  METHODS
  Participants in a cohort study of persons with HIV on HAART with at least 4 consecutive semiannual study visits were included (n = 225). Incident depression was defined as having 2 visits with a negative depression screening test followed by 2 visits with a positive test. Comparison group participants had 4 consecutive visits with a negative depression screening test. Suboptimal adherence was defined as missing >5% of HAART doses in the past 7 days. We compared suboptimal adherence rates in those with and without incident depression symptoms and estimated the relative risk and 95% confidence intervals of suboptimal adherence at visit 4 in those adherent at baseline (n = 177), controlling for sociodemographic, behavioral, and clinical variables.
  
  
  RESULTS
  Twenty-two percent developed depression symptoms. Those developing depression symptoms had higher rates of suboptimal adherence at follow-up (45.1% vs. 25.9%, P < 0.01). Among those with optimal baseline adherence, those with incident depression were nearly 2 times more likely to develop suboptimal adherence (Adjusted relative risk =1.8, 95% confidence interval =1.1 to 3.0) at follow-up.
  
  
  CONCLUSIONS
  Incident depression symptoms were associated with subsequent suboptimal HAART adherence. Ongoing aggressive screening for, and treatment of, depression may improve HAART outcomes.
authors.affiliation: Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA. deborah.kacanek@tufts.edu
authors.forename: Deborah
authors.initials: D
authors.lastname: Kacanek
authors.forename: Denise L
authors.initials: DL
authors.lastname: Jacobson
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Christine
authors.initials: C
authors.lastname: Wanke
authors.forename: Rita
authors.initials: R
authors.lastname: Isaac
authors.forename: Ira B
authors.initials: IB
authors.lastname: Wilson
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000523:psychology*; D044469:Racial Groups; D012959:Socioeconomic Factors; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents