A Closer Look at Depression and Its Relationship to HIV Antiretroviral Adherence
Published Date:Dec 2011
Source:Ann Behav Med. 42(3):352-360.
Antiretroviral Therapy, Highly Active
Cognitive Depressive Symptoms
Severity Of Illness Index
Pubmed Central ID:PMC3226751
Funding:AI069419/AI/NIAID NIH HHS/United States
AI38858/AI/NIAID NIH HHS/United States
CC02-SD-003/CC/ODCDC CDC HHS/United States
CC99-SD003/CC/ODCDC CDC HHS/United States
K02DA017277/DA/NIDA NIH HHS/United States
K23MH01862/MH/NIMH NIH HHS/United States
P01MH49548/MH/NIMH NIH HHS/United States
R01 MH054907/MH/NIMH NIH HHS/United States
R01 MH068197/MH/NIMH NIH HHS/United States
R01 MH078773/MH/NIMH NIH HHS/United States
R01 MH078773-01A1/MH/NIMH NIH HHS/United States
R01AI41413/AI/NIAID NIH HHS/United States
R01DA015679/DA/NIDA NIH HHS/United States
R01DA11869/DA/NIDA NIH HHS/United States
R01DA13826/DA/NIDA NIH HHS/United States
R01DA15215/DA/NIDA NIH HHS/United States
R01MH01584/MH/NIMH NIH HHS/United States
R01MH078773/MH/NIMH NIH HHS/United States
R01MH54907/MH/NIMH NIH HHS/United States
R01MH58986/MH/NIMH NIH HHS/United States
R01MH61173/MH/NIMH NIH HHS/United States
R01MH61695/MH/NIMH NIH HHS/United States
R01MH68197/MH/NIMH NIH HHS/United States
R01NR04749/NR/NINR NIH HHS/United States
Depression consistently predicts nonadherence to human immunodeficiency virus (HIV) antiretroviral therapy, but which aspects of depression are most influential is unknown. Such knowledge could inform assessments of adherence readiness and the type of depression treatment to utilize.
We examined how depression severity, symptom type and change over time relate to adherence.
Microelectronic adherence and self-reported depression data from 1374 participants across merged studies were examined with cross-sectional and longitudinal analyses. Depression variables included a continuous measure, categorical measure of severity, cognitive and vegetative subscales, and individual symptoms.
At baseline, mean adherence was 69%, and 25% had mild/moderate and 18% had severe depression. In cross-sectional multivariate analyses, continuous depression, cognitive depressive symptoms and severe depression were associated with lower adherence. In longitudinal analysis, reductions in both continuous and categorical depression predicted increased adherence.
The relationship between global continuous depression and nonadherence was statistically significant, but relatively weak compared to that of cognitive depressive symptoms and severe depression, which appear to pose strong challenges to adherence and call for the need for early detection and treatment of depression.
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