Format

Send to

Choose Destination
J Acquir Immune Defic Syndr. 2018 Nov 1;79(3):283-287. doi: 10.1097/QAI.0000000000001803.

Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV.

Author information

1
Epidemiology, University of Washington, Seattle, WA.
2
Medicine and Epidemiology, University of Washington, Seattle, WA.
3
Medicine and Epidemiology, Yale School of Medicine, New Haven, CT.
4
Biostatistics, University of Washington, Seattle, WA.
5
Criminology, Law and Society, George Mason University, Fairfax, VA.
6
Medicine and Epidemiology, Johns Hopkins University, Baltimore, MD.
7
Epidemiology, Johns Hopkins University, Baltimore, MD.
8
Medicine, University of Washington, Seattle, WA.
9
Pharmacy, University of Washington, Seattle, WA.
10
Medicine and Epidemiology, University of North Carolina, Chapel Hill, NC.
11
Medicine, University of California San Francisco, San Francisco, CA.
12
Clinical Medicine, University of California San Diego, San Diego, CA.
13
Global Health and Population, Harvard University, Boston, MA.
14
Medicine, Johns Hopkins University, Baltimore, MD.
15
Medicine, University of Alabama, Birmingham, AL.
16
Medicine and Nursing, Yale School of Medicine, New Haven, CT.
17
National Institute of Drug Abuse, Washington, DC.

Abstract

PURPOSE:

Substance use is linked with poor outcomes among people living with HIV (PLWH) and is associated with mental health disorders. This analysis examines the impact of decreasing substance use, even without abstinence, on depressive symptoms among PLWH.

METHODS:

Data are from PLWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Sites cohort. Participants completed longitudinal assessments of substance use (modified ASSIST) and depressive symptoms (PHQ-9). Changes in substance use frequency were categorized as abstinence, reduced use, and nondecreasing use. Adjusted linear mixed models with time-updated change in substance use frequency and depressive symptom scores were used to examine associations between changes in the use of individual substances and depressive symptoms. Analyses were repeated using joint longitudinal survival models to examine associations with a high (PHQ-9 ≥10) score.

RESULTS:

Among 9905 PLWH, 728 used cocaine/crack, 1016 used amphetamine-type substances (ATS), 290 used illicit opiates, and 3277 used marijuana at baseline. Changes in ATS use were associated with the greatest improvements in depressive symptoms: stopping ATS led to a mean decrease of PHQ-9 by 2.2 points (95% CI: 1.8 to 2.7) and a 61% lower odds of PHQ-9 score ≥10 (95% CI: 0.30 to 0.52), and decreasing ATS use led to a mean decrease of 1.7 points (95% CI: 1.2 to 2.3) and a 62% lower odds of PHQ-9 score ≥10 (95% CI: 0.25 to 0.56). Stopping and reducing marijuana and stopping cocaine/crack use were also associated with improvement in depressive symptoms.

CONCLUSIONS:

We demonstrated that both substance use reduction and abstinence are associated with improvements in depressive symptoms over time.

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center