title: Determinants of benzodiazepine use in a representative population of HIV-infected individuals: the role of HIV status disclosure (ANRS-EN12-VESPA study).
abstract: HIV infection may result in stressful situations such as disclosure to others and could be a mediator between seropositivity status and psychiatric illness, depression, or anxiety. Several results have shown that anxiolytic use (mainly benzodiazepines [BDZ]) is highly prevalent in HIV-infected individuals, but few studies have highlighted to what extent this use could be associated with HIV disclosure. A national cross-sectional survey representative of people living with HIV and AIDS in France enrolled 2932 individuals in 102 French HIV hospital departments. Face-to-face interviews and self-administered questions collected information about patients' experience with HIV and HIV care, including use of psychotropic drugs, social support, stigma, and disclosure of HIV status. We identified factors associated with regular BDZ use (i.e., more than once a week) using a weighted logistic regression model. Regular BDZ use and anxiety symptoms were reported by 16% and 29% of the patients, respectively. After multiple adjustment for known correlates of BDZ use and anxiety symptoms, individuals who had disclosed their HIV status to relatives or friends were found to be more likely (OR [95% CI] = 1.78 [1.02-3.09]) to regularly use BDZ. These results show both to what extent disclosure to others continues to be a stressful step in the course of HIV infection and that disclosure is something that could be identified by BDZ use. They also highlight the need for appropriate case management and psychiatric care to help patients manage the consequences of disclosure.
authors.affiliation: INSERM, U, Marseille, France. perrine.roux@inserm.fr
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.forename: Lionel
authors.initials: L
authors.lastname: Fugon
authors.forename: Laurent
authors.initials: L
authors.lastname: Michel
authors.forename: France
authors.initials: F
authors.lastname: Lert
authors.forename: Yolande
authors.initials: Y
authors.lastname: Obadia
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D001569:Benzodiazepines / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012307:Risk Factors; D057545:Social Stigma; D012944:Social Support; D013315:Stress, Psychological; D014342:Truth Disclosure
chemical_list: D001569:Benzodiazepines