title: The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers.
abstract: BACKGROUND
  Depressive symptoms have been linked to HIV progression through a number of biobehavioral mechanisms including increased alcohol use. Although research supports an association between alcohol use and depressive symptoms among HIV patients, there have been few studies that have examined whether depressive symptoms predict subsequent drinking, especially among heavy drinking HIV-infected patients.
  
  
  METHODS
  Heavy drinking Russian HIV-infected patients (n=700) were recruited from addiction and HIV care settings for a randomized controlled trial of a risk reduction intervention [HERMITAGE]. GEE overdispersed Poisson regression analyses were conducted to assess the association between depressive symptoms and alcohol consumption 6-months later.
  
  
  RESULTS
  In adjusted analyses, depressive symptom severity was significantly associated with drinks per day (global p=.02). Compared to the non-depressed category, mild depressive symptoms were significantly associated with more drinks per day [IRR=1.55, (95% CI: 1.14, 2.09)], while moderate [IRR=1.14, (95% CI: 0.83, 1.56)] and severe [IRR=1.48, (95% CI: 0.93, 2.34)] depressive symptoms were not. Associations between depressive symptom severity and heavy drinking days were not statistically significant (global p=.19). Secondary analyses using the BDI-II screening threshold (BDI-II>14) and the BDI-II cognitive subscale suggested an association between depressive symptoms and drinks per day over time but not heavy episodic drinking.
  
  
  CONCLUSIONS
  Among heavy drinking HIV-infected patients, elevated depressive symptoms were associated with greater subsequent alcohol use. These findings suggest that depressive symptoms may be important to address in efforts to reduce alcohol-related risks among HIV-infected populations.
authors.affiliation: Department of Psychology, Boston University, 648 Beacon Street, Boston, MA 02021, USA. Electronic address: palfai@bu.edu.
authors.forename: T P
authors.initials: TP
authors.lastname: Palfai
authors.affiliation: Department of Biostatistics, School of Public Health, Boston University, Crosstown Center, 801 Massachusetts Avenue, Boston, MA 02218, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Cheng
authors.affiliation: Department of Biostatistics, School of Public Health, Boston University, Crosstown Center, 801 Massachusetts Avenue, Boston, MA 02218, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Coleman
authors.affiliation: Department of Medicine, Boston University School of Medicine, Crosstown Center, 801 Massachusetts Avenue, Boston, MA 02218, USA.
authors.forename: C
authors.initials: C
authors.lastname: Bridden
authors.affiliation: St. Petersburg Bekhterev Research Psychoneurological Institute, 3 Bekhterev Street, St. Petersburg 192019, Russia.
authors.forename: E
authors.initials: E
authors.lastname: Krupitsky
authors.affiliation: Department of Medicine, Boston University School of Medicine, Crosstown Center, 801 Massachusetts Avenue, Boston, MA 02218, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012426:Russia / Q000453:epidemiology; D055502:Secondary Prevention / Q000379:methods
keywords: Alcohol; BDI-II; Depression; HIV; Heavy drinking; Russia