Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
J Affect Disord. 2024 Jan 1;344:674-681. doi: 10.1016/j.jad.2023.10.057. Epub 2023 Oct 11.
Depression and alcohol use are common among people living with HIV (PLWH) and associated with adverse outcomes. However, there is a paucity of studies exploring trajectories of depressive symptom presence over time among alcohol consuming men PLWH.
Men PLWH were repeatedly assessed for depressive symptoms from baseline through 27 months using the 10-item Center for Epidemiologic Studies-Depression scale. Group-based trajectory modeling was used to identify trajectories of depressive symptoms over time among control (n = 188) and intervention participants (n = 564). Multinomial logistic regression was used to explore the relationship between trajectory subgroups and baseline independent variables.
Among intervention participants, the three subgroups were characterized as 'low' (85.8 % of the participants), 'fluctuating' (8.7 %), and 'persistently increasing' symptoms (5.5 %). Similarly, three trajectory subgroups among control participants were labeled as: "low" (54.4 %); "fluctuating" (33.5 %) and "persistently increasing'" (12.1 %). Among intervention participants, longer duration since HIV diagnosis (aOR: 1.05, 95 % CI: 1.01-1.12) and HIV-related stigma (aOR: 1.09, 95 % CI: 1.02-1.18) were associated with persistently increasing depressive symptoms trajectory. Further, alcohol drinking problems (aOR: 1.10, 95 % CI: 1.04-1.17) was associated with fluctuating depressive symptoms trajectory. Among control participants, only lower overall self-rated health status was associated with persistently increasing depressive symptoms trajectory (aOR: 0.96, 95 % CI: 0.93-0.99).
Selection bias; Information bias; Lack of causal interference; Generalizability.
Identifying subgroups of men PLWH with different depressive symptoms trajectories may inform effective and tailored intervention approaches to address mental health treatment and prevention among alcohol consuming men PLWH in India and elsewhere.
抑郁和饮酒在 HIV 感染者（PLWH）中很常见，并且与不良后果相关。然而，目前很少有研究探索在饮酒的 PLWH 男性中，随着时间推移，抑郁症状的存在轨迹。
使用 10 项中心流行病学研究抑郁量表（Center for Epidemiologic Studies-Depression scale），从基线到 27 个月，反复评估 PLWH 男性的抑郁症状。采用基于群组的轨迹建模来确定对照组（n=188）和干预组（n=564）中随着时间推移的抑郁症状轨迹。使用多项逻辑回归来探索轨迹亚组与基线自变量之间的关系。
在干预组参与者中，三个亚组的特征为“低”（85.8%的参与者）、“波动”（8.7%）和“持续增加”症状（5.5%）。同样，对照组参与者中的三个轨迹亚组被标记为：“低”（54.4%）、“波动”（33.5%）和“持续增加”（12.1%）。在干预组参与者中，HIV 诊断后时间较长（OR：1.05，95%CI：1.01-1.12）和 HIV 相关耻辱感（OR：1.09，95%CI：1.02-1.18）与持续增加的抑郁症状轨迹相关。此外，饮酒问题（OR：1.10，95%CI：1.04-1.17）与波动的抑郁症状轨迹相关。在对照组参与者中，只有较低的总体自我评估健康状况与持续增加的抑郁症状轨迹相关（OR：0.96，95%CI：0.93-0.99）。
选择偏倚；信息偏倚；缺乏因果干预；普遍性。
确定具有不同抑郁症状轨迹的 PLWH 男性亚组，可能为在印度和其他地区，针对饮酒的 PLWH 提供有效的、有针对性的干预方法，以解决心理健康治疗和预防问题。
