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PLoS One. 2018 Jan 24;13(1):e0191548. doi: 10.1371/journal.pone.0191548. eCollection 2018.

Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam.

Author information

1
University of North Carolina, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, United States of America.
2
University of North Carolina, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, NC, United States of America.
3
Thai Nguyen Center for Preventive Medicine, Thai Nguyen, Vietnam.
4
Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, United States of America.
5
Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, United States of America.
6
Johns Hopkins Bloomberg School of Public Health, Department of Biostatistics, Baltimore, MD, United States of America.

Abstract

BACKGROUND:

HIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam.

METHODS:

We used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009-2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D≥23) with prevalence odds ratios (POR) and 95% confidence intervals (CI).

RESULTS:

The prevalence of severe depressive symptoms (CES-D≥23) was 44%. 25% of participants had mild to moderate depressive symptoms (16≤CES-D<23), and 31% experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95% CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95% CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95% CI = 1.40, 3.47).

CONCLUSION:

Severe depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.

PMID:
29364928
PMCID:
PMC5783407
DOI:
10.1371/journal.pone.0191548
[Indexed for MEDLINE]
Free PMC Article

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