Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam

Sara N. Levintow, Brian W. Pence, Tran Viet Ha, Nguyen Le Minh, Teerada Sripaipan, Carl A Latkin, Pham The Vu, Vu Minh Quan, Constantine Frangakis, Vivian F. Go

Research output: Contribution to journalArticle

Abstract

Background HIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam. Methods We used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009–2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D23) with prevalence odds ratios (POR) and 95% confidence intervals (CI). Results The prevalence of severe depressive symptoms (CES-D23) was 44%. 25% of participants had mild to moderate depressive symptoms (16CES-D<23), and 31% experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95% CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95% CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95% CI = 1.40, 3.47). Conclusion Severe depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.

Original languageEnglish (US)
Article numbere0191548
JournalPLoS One
Volume13
Issue number1
DOIs
StatePublished - Jan 1 2018

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Vietnam
HIV
Depression
drugs
odds ratio
confidence interval
Pharmaceutical Preparations
epidemiological studies
demographic statistics
alcohols
Odds Ratio
Confidence Intervals
drug injection
drug abuse
risk behavior
overdose
smoking (habit)
Alcohols
Health
psychosocial factors

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Levintow, S. N., Pence, B. W., Ha, T. V., Le Minh, N., Sripaipan, T., Latkin, C. A., ... Go, V. F. (2018). Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam. PLoS One, 13(1), [e0191548]. https://doi.org/10.1371/journal.pone.0191548

Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam. / Levintow, Sara N.; Pence, Brian W.; Ha, Tran Viet; Le Minh, Nguyen; Sripaipan, Teerada; Latkin, Carl A; Vu, Pham The; Quan, Vu Minh; Frangakis, Constantine; Go, Vivian F.

In: PLoS One, Vol. 13, No. 1, e0191548, 01.01.2018.

Research output: Contribution to journalArticle

Levintow, Sara N. ; Pence, Brian W. ; Ha, Tran Viet ; Le Minh, Nguyen ; Sripaipan, Teerada ; Latkin, Carl A ; Vu, Pham The ; Quan, Vu Minh ; Frangakis, Constantine ; Go, Vivian F. / Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam. In: PLoS One. 2018 ; Vol. 13, No. 1.
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abstract = "Background HIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam. Methods We used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009–2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D23) with prevalence odds ratios (POR) and 95{\%} confidence intervals (CI). Results The prevalence of severe depressive symptoms (CES-D23) was 44{\%}. 25{\%} of participants had mild to moderate depressive symptoms (16CES-D<23), and 31{\%} experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95{\%} CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95{\%} CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95{\%} CI = 1.40, 3.47). Conclusion Severe depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.",
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AB - Background HIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam. Methods We used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009–2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D23) with prevalence odds ratios (POR) and 95% confidence intervals (CI). Results The prevalence of severe depressive symptoms (CES-D23) was 44%. 25% of participants had mild to moderate depressive symptoms (16CES-D<23), and 31% experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95% CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95% CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95% CI = 1.40, 3.47). Conclusion Severe depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.

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