Background Depression, substance abuse, and alcohol abuse are known to play a significant role in chronic diseases and especially afflict persons living with HIV (PLWH). The purpose of this study is to report the prevalence of these disorders in a population of PLWH and identify predisposing correlates.
Methods A voluntary, IRB-approved questionnaire was offered to patients presenting to the University of Kentucky HIV clinic. Depression was assessed with both self-reported medical history as well as the 9-item Patient Health Questionnaire Depression Scale (PHQ-9). Substance abuse was assessed with the 10-item Short Drug Abuse Screening Test (DAST-10) and 10-item Alcohol Use Disorders Identification Test (AUDIT). Self-reported demographic information was also collected. The data were analyzed through the use of simple means, standard errors, and Pearson product-moment correlations.
Results Of the 123 surveys delivered, 102 (82.9%) were returned. Demographic information finds: mean age 40.6 6 9.1 (22-67); 83% men; 80% Caucasian, 15% African American, 3% Hispanic, and 1% Asian; 67% are men who have sex with men (MSM), 14% indicate high-risk heterosexual activity (HRH), 4 (4%) intravenous drug use, 2% report blood exposure, and 13% do not know their HIV risk factor; 50% have depression, and 28.4% have anxiety. The proportion of worrisome scores on these measures were 57.8% (PHQ $ 5 indicating depression), 11.8% (DAST $ 3), and 9.3% (AUDIT $ 8). Individual PHQ item analysis finds that 66.33% feel depressed, 72.92% have difficulty sleeping, 68.13% have poor appetite, and 24.5% are suicidal. Regarding drug abuse, 43.43% have used drugs for nonmedical reasons, 11.22% have neglected their family because of drugs, and 13.27% are unable to stop using drugs. Most (91.67%) do not consume more than 1-2 drinks per week, but 26.04% report some binge-drinking and 11.34% have been told to cut down. Significant correlations include self-reported depression and anxiety with PHQ scores (r = .473, p < .001 and r = .341, p < .001, respectively), depression with nonwhites and less education (r = .26, p = .016 and r = .276, p = .01, respectively), and drug abuse with younger age (r = .36, p = .011).
Conclusions The data suggest that depression is quite rampant in this population. Alcohol and drug abuse do not appear disproportionate; however, the small but significant binge-drinking and inability to stop using drugs could conceivably affect their disease outcomes. Mental health disorders represent serious, common, but identifiable and treatable comorbid disease in an already vulnerable population.
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