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Trajectories of Depressive Symptoms Among a Population of HIV-Infected Men and Women in Routine HIV Care in the United States

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Abstract

Depressive symptoms vary in severity and chronicity. We used group-based trajectory models to describe trajectories of depressive symptoms (measured using the Patient Health Questionnaire-9) and predictors of trajectory group membership among 1493 HIV-infected men (84%) and 292 HIV-infected women (16%). At baseline, 29% of women and 26% of men had depressive symptoms. Over a median of 30 months of follow-up, we identified four depressive symptom trajectories for women (labeled “low” [experienced by 56% of women], “mild/moderate” [24%], “improving” [14%], and “severe” [6%]) and five for men (“low” [61%], “mild/moderate” [14%], “rebounding” [5%], “improving” [13%], and “severe” [7%]). Baseline antidepressant prescription, panic symptoms, and prior mental health diagnoses were associated with more severe or dynamic depressive symptom trajectories. Nearly a quarter of participants experienced some depressive symptoms, highlighting the need for improved depression management. Addressing more severe or dynamic depressive symptom trajectories may require interventions that additionally address mental health comorbidities.

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Acknowledgements

The authors wish to thank the University of North Carolina at Chapel Hill Center for AIDS Research and National Institutes of Health [Grant Numbers R01MH100970, R24AI067039, P30 AI50410, L30MH110572, K99MH112413, and UL1TR001111], which supported this work. Dr. Bengtson was supported by a career development award from the National Institute of Mental Health [Grant Number K99MH112413].

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Authors and Affiliations

  1. Department of Epidemiology, University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA

    Angela M. Bengtson, Brian W. Pence & Kimberly A. Powers

  2. School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Mark A. Weaver

  3. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Mark A. Weaver

  4. Departments of Behavioral & Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, RI, USA

    Matthew J. Mimiaga

  5. Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA

    Matthew J. Mimiaga

  6. The Center for Health Equity Research, Brown University, Providence, RI, USA

    Matthew J. Mimiaga

  7. Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Bradley N. Gaynes

  8. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Conall O’Cleirigh

  9. Harvard Medical School, Harvard University, Boston, MA, USA

    Conall O’Cleirigh

  10. The Fenway Institute, Fenway Health, Boston, MA, USA

    Conall O’Cleirigh

  11. HIV/AIDS Division, San Francisco General Hospital, University of California, San Francisco, CA, USA

    Katerina Christopoulos

  12. Department of Medicine, School of Medicine, University of California, San Diego, CA, USA

    W. Christopher Mathews

  13. Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA

    Heidi Crane

  14. Department of Medicine and UAB Center for AIDS Research, University of Alabama at Birmingham, Birmingham, AL, USA

    Michael Mugavero

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  1. Angela M. Bengtson
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  11. Michael Mugavero
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Corresponding author

Correspondence to Angela M. Bengtson.

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The authors declare no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board at each CNICS site and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent to participate in the CNICS cohort was obtained from all individual participants included in the study.

Informed Consent

Informed consent to participate in the CNICS cohort was obtained from all individual participants included in the study.

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Bengtson, A.M., Pence, B.W., Powers, K.A. et al. Trajectories of Depressive Symptoms Among a Population of HIV-Infected Men and Women in Routine HIV Care in the United States. AIDS Behav 22, 3176–3187 (2018). https://doi.org/10.1007/s10461-018-2109-2

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