Association between depression and HIV treatment outcomes in a US military population with HIV infection
Abstract Background Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and subsequent inability to attain viral load (VL) suppression. We evaluated associations between depression, self-reported adherence, and longitudinal H...
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doaj-0ace82e1f04e42fcb4f46e36231ca2fe2021-05-16T11:21:06ZengBMCAIDS Research and Therapy1742-64052021-05-011811610.1186/s12981-021-00350-2Association between depression and HIV treatment outcomes in a US military population with HIV infectionBrandon Carney0Colton Daniels1Xiaohe Xu2Thankam Sunil3Anuradha Ganesan4Jason M. Blaylock5Karl C. Kronmann6Christina Schofield7Tahaniyat Lalani8Brian Agan9Jason F. Okulicz10Brooke Army Medical CenterDepartment of Sociology, University of Texas at San AntonioDepartment of Sociology, University of Texas at San AntonioInstitute for Health Disparities Research, University of Texas At San AntonioInfectious Disease Clinical Research Program, Department of Preventive Medicine, Uniformed Services University of the Health SciencesWalter Reed National Military Medical CenterNaval Medical CenterMadigan Army Medical CenterInfectious Disease Clinical Research Program, Department of Preventive Medicine, Uniformed Services University of the Health SciencesInfectious Disease Clinical Research Program, Department of Preventive Medicine, Uniformed Services University of the Health SciencesBrooke Army Medical CenterAbstract Background Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and subsequent inability to attain viral load (VL) suppression. We evaluated associations between depression, self-reported adherence, and longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with and without depression. Methods Male NHS participants with available ICD-9 data for mental health diagnoses, Center for Epidemiological Studies Depression (CES-D) measures, and self-reported adherence (SRA) were included. ART use was defined as ART initiation between 2006 and 2010, with follow-up through 2015. SRA was defined as taking 95% of ART doses and continuous ART was defined as longitudinal ART use with gaps < 30 days. Continuous VL suppression was defined as maintaining VLs < 200 c/mL on ART. To analyse the association between depression and HIV treatment outcomes, latent class analysis was used to create classes of depression trajectories: low depression (LD), recent onset depression (ROD) and high Depression (HD). Results Participants had a mean age of 32 (± 8.3) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). Overall, older participants at HIV diagnosis had greater odds of having 95% self-reported adherence (OR 1.06, 95% CI 1.02–1.12), and African Americans had lower odds (OR 0.41, 95% CI 0.22–0.76) compared to Caucasians (OR 1.49, 95% CI 0.52–4.28). However, there was no difference in SRA by depression trajectory. Participants with HD had an increased odds of taking ART continuously (OR 1.75, 95% CI 0.99–3.09), and those with ROD had significantly higher odds of virologic failure (OR 0.58, 95% CI 0.38–0.91). Conclusions Although there was no observed association between depression and SRA, participants with ROD had lower odds of attaining the HIV treatment goal of VL suppression. Continued efforts to identify and aggressively manage mental health disorders is important to success along the HIV care continuum.https://doi.org/10.1186/s12981-021-00350-2HIVDepressionAdherenceAntiretroviral therapyViral load suppression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Brandon Carney Colton Daniels Xiaohe Xu Thankam Sunil Anuradha Ganesan Jason M. Blaylock Karl C. Kronmann Christina Schofield Tahaniyat Lalani Brian Agan Jason F. Okulicz |
spellingShingle |
Brandon Carney Colton Daniels Xiaohe Xu Thankam Sunil Anuradha Ganesan Jason M. Blaylock Karl C. Kronmann Christina Schofield Tahaniyat Lalani Brian Agan Jason F. Okulicz Association between depression and HIV treatment outcomes in a US military population with HIV infection AIDS Research and Therapy HIV Depression Adherence Antiretroviral therapy Viral load suppression |
author_facet |
Brandon Carney Colton Daniels Xiaohe Xu Thankam Sunil Anuradha Ganesan Jason M. Blaylock Karl C. Kronmann Christina Schofield Tahaniyat Lalani Brian Agan Jason F. Okulicz |
author_sort |
Brandon Carney |
title |
Association between depression and HIV treatment outcomes in a US military population with HIV infection |
title_short |
Association between depression and HIV treatment outcomes in a US military population with HIV infection |
title_full |
Association between depression and HIV treatment outcomes in a US military population with HIV infection |
title_fullStr |
Association between depression and HIV treatment outcomes in a US military population with HIV infection |
title_full_unstemmed |
Association between depression and HIV treatment outcomes in a US military population with HIV infection |
title_sort |
association between depression and hiv treatment outcomes in a us military population with hiv infection |
publisher |
BMC |
series |
AIDS Research and Therapy |
issn |
1742-6405 |
publishDate |
2021-05-01 |
description |
Abstract Background Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and subsequent inability to attain viral load (VL) suppression. We evaluated associations between depression, self-reported adherence, and longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with and without depression. Methods Male NHS participants with available ICD-9 data for mental health diagnoses, Center for Epidemiological Studies Depression (CES-D) measures, and self-reported adherence (SRA) were included. ART use was defined as ART initiation between 2006 and 2010, with follow-up through 2015. SRA was defined as taking 95% of ART doses and continuous ART was defined as longitudinal ART use with gaps < 30 days. Continuous VL suppression was defined as maintaining VLs < 200 c/mL on ART. To analyse the association between depression and HIV treatment outcomes, latent class analysis was used to create classes of depression trajectories: low depression (LD), recent onset depression (ROD) and high Depression (HD). Results Participants had a mean age of 32 (± 8.3) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). Overall, older participants at HIV diagnosis had greater odds of having 95% self-reported adherence (OR 1.06, 95% CI 1.02–1.12), and African Americans had lower odds (OR 0.41, 95% CI 0.22–0.76) compared to Caucasians (OR 1.49, 95% CI 0.52–4.28). However, there was no difference in SRA by depression trajectory. Participants with HD had an increased odds of taking ART continuously (OR 1.75, 95% CI 0.99–3.09), and those with ROD had significantly higher odds of virologic failure (OR 0.58, 95% CI 0.38–0.91). Conclusions Although there was no observed association between depression and SRA, participants with ROD had lower odds of attaining the HIV treatment goal of VL suppression. Continued efforts to identify and aggressively manage mental health disorders is important to success along the HIV care continuum. |
topic |
HIV Depression Adherence Antiretroviral therapy Viral load suppression |
url |
https://doi.org/10.1186/s12981-021-00350-2 |
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