title: Psychiatric context of human immunodeficiency virus infection among former plasma donors in rural China.
abstract: BACKGROUND
  China's HIV epidemic commenced in its agrarian provinces through contaminated commercial plasma donation centers and is now becoming a public health concern nationwide. Little is known of the psychiatric and substance use disorder characteristics of this population, or their impact on everyday function, employment, and life quality.
  
  
  METHODS
  HIV-infected (HIV+) former plasma donors (N=203) and HIV-negative (HIV-) donor controls (N=198) completed the World Mental Health Survey Composite International Diagnostic Interview to determine lifetime major depressive disorder (MDD), substance use disorders, and suicidality. Current mood and suicidality were assessed with the Beck Depression Inventory-II. Everyday function was measured by an Activity of Daily Living questionnaire; life quality was evaluated by the Medical Outcomes Study-HIV.
  
  
  RESULTS
  HIV+ participants had known their infected status for 2 years on average. Most were taking antiretroviral treatment and had frank AIDS. Rates of current MDD were similar across groups (1-2%), but HIV+ had a higher frequency of lifetime MDD (14% vs. 5%, p<.05). Its onset preceded date of known infection in one-third of cases. Alcoholism was the only substance use disorder detected; HIV+ had a higher proportion of lifetime substance use diagnoses (14% vs. 6%, p<.05). Depression and AIDS independently predicted worse daily functioning and life quality, and unemployment.
  
  
  CONCLUSIONS
  The epicenter of China HIV has moved into urban injection drug users, limiting the representativeness of this sample.
  
  
  CONCLUSIONS
  High rates of MDD and its impact suggest that in China, as elsewhere, comprehensive care requires detection and treatment of mood disorder.
authors.affiliation: HIV Neurobehavioral Research Center, University of California, San Diego, 220 Dickinson St., San Diego, CA 92103, USA. jhatkinson@ucsd.edu
authors.forename: J Hampton
authors.initials: JH
authors.lastname: Atkinson
authors.forename: Hua
authors.initials: H
authors.lastname: Jin
authors.forename: Chuan
authors.initials: C
authors.lastname: Shi
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.forename: Nichole A
authors.initials: NA
authors.lastname: Duarte
authors.forename: Corinna Young
authors.initials: CY
authors.lastname: Casey
authors.forename: Donald R
authors.initials: DR
authors.lastname: Franklin
authors.forename: Ofilio
authors.initials: O
authors.lastname: Vigil
authors.forename: Lucette
authors.initials: L
authors.lastname: Cysique
authors.forename: Tanya
authors.initials: T
authors.lastname: Wolfson
authors.forename: P Katie
authors.initials: PK
authors.lastname: Riggs
authors.forename: Saurabh
authors.initials: S
authors.lastname: Gupta
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000293:Adolescent; D000328:Adult; D001782:Blood Donors / Q000523:psychology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult