Abstract
Appearance concerns are common among HIV-infected individuals, and previous cross-sectional and longitudinal data indicate that these concerns are associated with antiretroviral therapy (ART) non-adherence. However, to date, no known prospective data have explored the mechanism behind this relationship. Thus, the aim of the current study was to test depression severity as a prospective mediator of the relationship between appearance concerns and ART non-adherence in HIV-infected individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals with a history of IDU who participated in a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence. Clinician- administered measures of depression severity and appearance concerns, along with electronic monitoring of ART non-adherence were included. Data were analyzed using longitudinal linear mixed-level modeling, and mediation was tested via the Monte Carlo Method of Assessing Mediation. Appearance concerns were predictive of depression severity, γ =.31, SE =.076, 95 % CI [.16,.46], t = 4.1, p =.0001, and depression severity was predictive of ART non-adherence, γ = 3.3, SE = 1.3, 95 % CI [.8, 5.8], t = 2.6, p =.01. The effect of appearance concerns on ART non-adherence, however, was significantly mediated by depression severity, γ = 1.02, 95 % CI [.21, 2.1]. Appearance concerns are associated with depression severity, which in turn is associated with ART non-adherence. Integrative interventions addressing appearance concerns, depression and ART adherence are needed, as this is one potential pathway towards worse health outcomes in HIV-infected individuals.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 166-172 |
| Number of pages | 7 |
| Journal | Journal of Behavioral Medicine |
| Volume | 37 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2014 |
| Externally published | Yes |
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Keywords
- Appearance
- ART adherence
- Body image
- Depression
- HIV/AIDS
- Lipodystrophy
ASJC Scopus subject areas
- Psychology(all)
- Psychiatry and Mental health
Cite this
Depression longitudinally mediates the association of appearance concerns to ART non-adherence in HIV-infected individuals with a history of injection drug use. / Blashill, Aaron J.; Gordon, Janna R.; Safren, Steven.
In: Journal of Behavioral Medicine, Vol. 37, No. 1, 02.2014, p. 166-172.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Depression longitudinally mediates the association of appearance concerns to ART non-adherence in HIV-infected individuals with a history of injection drug use
AU - Blashill, Aaron J.
AU - Gordon, Janna R.
AU - Safren, Steven
PY - 2014/2
Y1 - 2014/2
N2 - Appearance concerns are common among HIV-infected individuals, and previous cross-sectional and longitudinal data indicate that these concerns are associated with antiretroviral therapy (ART) non-adherence. However, to date, no known prospective data have explored the mechanism behind this relationship. Thus, the aim of the current study was to test depression severity as a prospective mediator of the relationship between appearance concerns and ART non-adherence in HIV-infected individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals with a history of IDU who participated in a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence. Clinician- administered measures of depression severity and appearance concerns, along with electronic monitoring of ART non-adherence were included. Data were analyzed using longitudinal linear mixed-level modeling, and mediation was tested via the Monte Carlo Method of Assessing Mediation. Appearance concerns were predictive of depression severity, γ =.31, SE =.076, 95 % CI [.16,.46], t = 4.1, p =.0001, and depression severity was predictive of ART non-adherence, γ = 3.3, SE = 1.3, 95 % CI [.8, 5.8], t = 2.6, p =.01. The effect of appearance concerns on ART non-adherence, however, was significantly mediated by depression severity, γ = 1.02, 95 % CI [.21, 2.1]. Appearance concerns are associated with depression severity, which in turn is associated with ART non-adherence. Integrative interventions addressing appearance concerns, depression and ART adherence are needed, as this is one potential pathway towards worse health outcomes in HIV-infected individuals.
AB - Appearance concerns are common among HIV-infected individuals, and previous cross-sectional and longitudinal data indicate that these concerns are associated with antiretroviral therapy (ART) non-adherence. However, to date, no known prospective data have explored the mechanism behind this relationship. Thus, the aim of the current study was to test depression severity as a prospective mediator of the relationship between appearance concerns and ART non-adherence in HIV-infected individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals with a history of IDU who participated in a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence. Clinician- administered measures of depression severity and appearance concerns, along with electronic monitoring of ART non-adherence were included. Data were analyzed using longitudinal linear mixed-level modeling, and mediation was tested via the Monte Carlo Method of Assessing Mediation. Appearance concerns were predictive of depression severity, γ =.31, SE =.076, 95 % CI [.16,.46], t = 4.1, p =.0001, and depression severity was predictive of ART non-adherence, γ = 3.3, SE = 1.3, 95 % CI [.8, 5.8], t = 2.6, p =.01. The effect of appearance concerns on ART non-adherence, however, was significantly mediated by depression severity, γ = 1.02, 95 % CI [.21, 2.1]. Appearance concerns are associated with depression severity, which in turn is associated with ART non-adherence. Integrative interventions addressing appearance concerns, depression and ART adherence are needed, as this is one potential pathway towards worse health outcomes in HIV-infected individuals.
KW - Appearance
KW - ART adherence
KW - Body image
KW - Depression
KW - HIV/AIDS
KW - Lipodystrophy
UR - http://www.scopus.com/inward/record.url?scp=84894905783&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894905783&partnerID=8YFLogxK
U2 - 10.1007/s10865-012-9476-3
DO - 10.1007/s10865-012-9476-3
M3 - Article
C2 - 23180286
AN - SCOPUS:84894905783
VL - 37
SP - 166
EP - 172
JO - Journal of Behavioral Medicine
JF - Journal of Behavioral Medicine
SN - 0160-7715
IS - 1
ER -