Effects of depression and anxiety on antiretroviral therapy adherence among newly diagnosed HIV-infected Chinese MSM.
Our objective was to explore the effect of depression and anxiety on adherence to antiretroviral therapy (ART) among MSM with newly diagnosed HIV infections.



We conducted a prospective study of Chinese MSM with newly diagnosed HIV infections.



The Hospital Anxiety and Depression Scale was used to measure depression and anxiety at baseline, 6 and 12 months, separately. ART adherence was self-reported once every 3 months ('perfect' or no missing dose in the past 3 months vs. 'imperfect' adherence or at least one missing dose in the past 3 months). We utilized a priori substantial knowledge guided by causal models to identify confounding covariates, and performed mixed-effect logistic regression to assess the effects of depression and anxiety on ART adherence.



We included 228 participants who initiated ART after HIV diagnosis and before the end of study. A one-unit increase in the depression and anxiety score was associated with a 16% increase [adjusted odds ratio (aOR), 1.16; 95% confidence interval (CI), 1.02-1.32] and a 17% increase (aOR, 1.17; 95% CI, 1.03-1.33) in the odds of reporting imperfect ART adherence, respectively. When depression and anxiety were categorized (normal, borderline, and likely), only likely anxiety had a significant association with imperfect ART adherence (aOR, 4.79; 95% CI, 1.12-20.50).



Depression and anxiety are risk factors for imperfect ART adherence among Chinese MSM with newly diagnosed HIV infections. Intensive intervention on depression and/or anxiety beyond regular post-HIV-testing counseling may increase adherence to ART, and improve HIV treatment outcomes.
aVanderbilt Institute for Global Health bDivision of Epidemiology, Departments of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA cState Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China dDepartments of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA eDepartment of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA fBeijing Center for Disease Control and Prevention, Beijing, China gDepartment of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Jun
J
Tao
Han-Zhu
HZ
Qian
Aaron M
AM
Kipp
Yuhua
Y
Ruan
Bryan E
BE
Shepherd
Kathy Rivet
KR
Amico
Yiming
Y
Shao
Hongyan
H
Lu
Sten H
SH
Vermund
D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D001007:Anxiety; D044466:Asian People; D003863:Depression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011446:Prospective Studies; D012307:Risk Factors; D000072339:Sexual and Gender Minorities
D044966:Anti-Retroviral Agents
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