Psychiatric risk factors for HIV disease progression

The role of inconsistent patterns of antiretroviral therapy utilization

Adam Carrico, Elise D. Riley, Mallory O. Johnson, Edwin D. Charlebois, Torsten B. Neilands, Robert H. Remien, Marguerita A. Lightfoot, Wayne T. Steward, Lance S. Weinhardt, Jeffrey A. Kelly, Mary Jane Rotheram-Borus, Stephen F. Morin, Margaret A. Chesney

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Background: In the era of antiretroviral therapy (ART), depression and substance use predict hastened HIV disease progression, but the underlying biological or behavioral mechanisms that explain these effects are not fully understood. Methods: Using outcome data from 603 participants enrolled in a randomized controlled trial of a behavioral intervention, binary logistic and linear regression were employed to examine whether inconsistent patterns of ART utilization partially mediated the effects of depression and substance use on higher HIV viral load over a 25-month follow-up. Results: Elevated affective symptoms of depression independently predicted ART discontinuation [adjusted odds ratio = 1.39, 95% confidence interval (CI) = 1.08 to 1.78], and use of stimulants at least weekly independently predicted intermittent ART utilization (adjusted odds ratio = 2.62, 95% CI = 1.45 to 4.73). After controlling for the average self-reported percentage of ART doses taken and baseline T-helper (CD4) count, elevated depressive symptoms predicted a 50% higher mean viral load, and weekly stimulant use predicted a 137% higher mean viral load. These effects became nonsignificant after accounting for inconsistent patterns of ART utilization, providing evidence of partial mediation. Conclusions: Inconsistent patterns of ART utilization may partially explain the effects of depression and stimulant use on hastened HIV disease progression.

Original languageEnglish (US)
Pages (from-to)146-150
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Volume56
Issue number2
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Fingerprint

Psychiatry
Disease Progression
HIV
Depression
Viral Load
Therapeutics
Odds Ratio
Confidence Intervals
Affective Symptoms
CD4 Lymphocyte Count
Linear Models
Randomized Controlled Trials
Logistic Models

Keywords

  • access
  • adherence
  • antiretroviral
  • cocaine
  • depression
  • disease progression
  • highly active
  • HIV viral load
  • HIV/AIDS
  • methamphetamine
  • substance use
  • utilization

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Psychiatric risk factors for HIV disease progression : The role of inconsistent patterns of antiretroviral therapy utilization. / Carrico, Adam; Riley, Elise D.; Johnson, Mallory O.; Charlebois, Edwin D.; Neilands, Torsten B.; Remien, Robert H.; Lightfoot, Marguerita A.; Steward, Wayne T.; Weinhardt, Lance S.; Kelly, Jeffrey A.; Rotheram-Borus, Mary Jane; Morin, Stephen F.; Chesney, Margaret A.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 56, No. 2, 01.02.2011, p. 146-150.

Research output: Contribution to journalArticle

Carrico, A, Riley, ED, Johnson, MO, Charlebois, ED, Neilands, TB, Remien, RH, Lightfoot, MA, Steward, WT, Weinhardt, LS, Kelly, JA, Rotheram-Borus, MJ, Morin, SF & Chesney, MA 2011, 'Psychiatric risk factors for HIV disease progression: The role of inconsistent patterns of antiretroviral therapy utilization', Journal of Acquired Immune Deficiency Syndromes, vol. 56, no. 2, pp. 146-150. https://doi.org/10.1097/QAI.0b013e318201df63
Carrico, Adam ; Riley, Elise D. ; Johnson, Mallory O. ; Charlebois, Edwin D. ; Neilands, Torsten B. ; Remien, Robert H. ; Lightfoot, Marguerita A. ; Steward, Wayne T. ; Weinhardt, Lance S. ; Kelly, Jeffrey A. ; Rotheram-Borus, Mary Jane ; Morin, Stephen F. ; Chesney, Margaret A. / Psychiatric risk factors for HIV disease progression : The role of inconsistent patterns of antiretroviral therapy utilization. In: Journal of Acquired Immune Deficiency Syndromes. 2011 ; Vol. 56, No. 2. pp. 146-150.
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