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

Joseph A. Delaney, Robin M. Nance, Bridget M. Whitney, Frederick L. Altice, Xinyuan Dong, Maria Esther Perez Trejo, Mika Matsuzaki, Faye S. Taxman, Geetanjali Chander, Irene Kuo, Rob Fredericksen, Lauren N. Strand, Joseph J. Eron, Elvin Geng, Mari M. Kitahata, William C. Mathews, Kenneth Mayer, Richard D Moore, Michael S. Saag, Sandra SpringerRedonna Chandler, Shoshana Kahana, Heidi M. Crane

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)283-287
Number of pages5
JournalJournal of acquired immune deficiency syndromes (1999)
Volume79
Issue number3
DOIs
StatePublished - Nov 1 2018

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HIV
Depression
Amphetamine
Crack Cocaine
Cannabis
Opiate Alkaloids
Mental Disorders
Linear Models
Mental Health
Acquired Immunodeficiency Syndrome
Joints
Research

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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Brief Report : Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV. / Delaney, Joseph A.; Nance, Robin M.; Whitney, Bridget M.; Altice, Frederick L.; Dong, Xinyuan; Trejo, Maria Esther Perez; Matsuzaki, Mika; Taxman, Faye S.; Chander, Geetanjali; Kuo, Irene; Fredericksen, Rob; Strand, Lauren N.; Eron, Joseph J.; Geng, Elvin; Kitahata, Mari M.; Mathews, William C.; Mayer, Kenneth; Moore, Richard D; Saag, Michael S.; Springer, Sandra; Chandler, Redonna; Kahana, Shoshana; Crane, Heidi M.

In: Journal of acquired immune deficiency syndromes (1999), Vol. 79, No. 3, 01.11.2018, p. 283-287.

Research output: Contribution to journalArticle

Delaney, JA, Nance, RM, Whitney, BM, Altice, FL, Dong, X, Trejo, MEP, Matsuzaki, M, Taxman, FS, Chander, G, Kuo, I, Fredericksen, R, Strand, LN, Eron, JJ, Geng, E, Kitahata, MM, Mathews, WC, Mayer, K, Moore, RD, Saag, MS, Springer, S, Chandler, R, Kahana, S & Crane, HM 2018, 'Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV', Journal of acquired immune deficiency syndromes (1999), vol. 79, no. 3, pp. 283-287. https://doi.org/10.1097/QAI.0000000000001803
Delaney, Joseph A. ; Nance, Robin M. ; Whitney, Bridget M. ; Altice, Frederick L. ; Dong, Xinyuan ; Trejo, Maria Esther Perez ; Matsuzaki, Mika ; Taxman, Faye S. ; Chander, Geetanjali ; Kuo, Irene ; Fredericksen, Rob ; Strand, Lauren N. ; Eron, Joseph J. ; Geng, Elvin ; Kitahata, Mari M. ; Mathews, William C. ; Mayer, Kenneth ; Moore, Richard D ; Saag, Michael S. ; Springer, Sandra ; Chandler, Redonna ; Kahana, Shoshana ; Crane, Heidi M. / Brief Report : Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV. In: Journal of acquired immune deficiency syndromes (1999). 2018 ; Vol. 79, No. 3. pp. 283-287.
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AU - Nance, Robin M.

AU - Whitney, Bridget M.

AU - Altice, Frederick L.

AU - Dong, Xinyuan

AU - Trejo, Maria Esther Perez

AU - Matsuzaki, Mika

AU - Taxman, Faye S.

AU - Chander, Geetanjali

AU - Kuo, Irene

AU - Fredericksen, Rob

AU - Strand, Lauren N.

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N2 - 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.

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