title: Factors Associated with Symptoms of Depression among Injection Drug Users Receiving Antiretroviral Treatment in Indonesia.
abstract: OBJECTIVE
  Few studies have examined psychiatric comorbidity among HIV positive injection drug users (IDUs) in resource-limiting settings. We sought to identify key factors associated with symptoms of depression among IDUs receiving antiretroviral (ARV) treatment in Jakarta and Denpasar, Indonesia.
  
  
  METHODS
  The cross-sectional study was conducted at five ARV delivery sites in Indonesia. Former IDUs aged 18 years or older having received ARV treatment for at least three months (n=117) were recruited and interviewed face-to-face. A 9-item version of the Center for Epidemiologic Studies Depression Scale was used to measure symptoms of depression. A structured questionnaire measured participants' demographic characteristics, social support and services received, current substance use, and treatment for drug dependency and HIV. Multiple logistic regression was used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI).
  
  
  RESULTS
  Of the 117 participants, 33% (39) exhibited symptoms of depression, 24% (28) reported using an illicit substance in the past month, and 29% (34) were in methadone treatment. Depressive symptoms were significantly associated with recent substance use in the last 30 days (AOR, 95% CI: 5.3, 1.9 to 15.4) and being on methadone (3.5, 1.2 to 10). Older age (per year 0.9, 0.8 to 1), full-time employment (0.2, 0.1 to 0.7), and living with parents (0.2, 0.1 to 0.6) appeared to be protective.
  
  
  CONCLUSIONS
  The results suggest that depression is common among Indonesian IDUs, even among patients enrolled in methadone treatment. HIV clinics and drug treatment programs need to recognize the risk/protective factors and also provide services to address this common comorbidity.
authors.affiliation: University of Illinois at Chicago School of Public Health, Department of Epidemiology-Biostatistics, Chicago, Illinois, USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: University of Illinois at Chicago School of Public Health, Department of Epidemiology-Biostatistics, Chicago, Illinois, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Hershow
authors.affiliation: Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
authors.lastname: Irwanto
authors.affiliation: Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
authors.forename: Ignatius
authors.initials: I
authors.lastname: Praptoraharjo
authors.affiliation: Udayana University, Denpasar, Indonesia.
authors.forename: Made
authors.initials: M
authors.lastname: Setiawan
authors.affiliation: University of Illinois at Chicago School of Public Health, Department of Health Policy and Administration, Chicago, Illinois, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Levy
keywords: Antiretroviral treatment; Depression; HIV; Indonesia; Injection drug use; Methadone; Psychiatric comorbidity