title: Sadness in the SUN: using computerized screening to analyze correlates of depression and adherence in HIV-infected adults in the United States.
abstract: We used a standardized screening tool to examine frequency of depression and its relation to antiretroviral medication adherence among HIV-infected persons on highly active antiretroviral therapy (HAART) in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study). This is a prospective observational cohort of 700 HIV-infected patients enrolled between March 2004 and June 2006 in four U.S. cities, who completed a confidential audio computer-assisted self-interview [ACASI] with behavioral risk and health-related questions at baseline and 6-month follow-up visits, including the nine-question PRIME-MD depression screener and a validated 3-day antiretroviral adherence question. Among 539 eligible participants receiving HAART, 14% had depression at baseline (22% women, 12% men). In multivariable analysis using generalized estimating equations (GEE) to account for repeated measurements through 24 months of follow-up, persons who reported depression on a given ACASI were twice as likely to report nonadherence to antiretrovirals on the same ACASI (Odds ratio [OR] 2.02, 95% CI: 1.15, 3.57] for mild/moderate depression versus none); such persons were also less likely to have HIV viral load<400 copies/mL. Self-administered computerized standardized screening tools can identify at-risk individuals with depression who may benefit from interventions to improve antiretroviral adherence.
authors.affiliation: Temple University School of Medicine, Philadelphia, PA, USA. etedaldi@temple.edu
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Tedaldi
authors.forename: Mary
authors.initials: M
authors.lastname: van den Berg-Wolf
authors.forename: James
authors.initials: J
authors.lastname: Richardson
authors.forename: Pragna
authors.initials: P
authors.lastname: Patel
authors.forename: Marcus
authors.initials: M
authors.lastname: Durham
authors.forename: John
authors.initials: J
authors.lastname: Hammer
authors.forename: Keith
authors.initials: K
authors.lastname: Henry
authors.forename: Sara
authors.initials: S
authors.lastname: Metzler
authors.forename: Nur
authors.initials: N
authors.lastname: Önen
authors.forename: Lois
authors.initials: L
authors.lastname: Conley
authors.forename: Kathy
authors.initials: K
authors.lastname: Wood
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
authors.forename: Kate
authors.initials: K
authors.lastname: Buchacz
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D016903:Drug Monitoring