Depressive Symptom Trajectories Among People Living with HIV in a Collaborative Care Program.
Douglas D GunzlerSteven LewisAllison WebelMallika LavakumarDiana GurleyKatherine KulpMcKenzie PileVictoria El-HayekAnn AveryPublished in: AIDS and behavior (2020)
Depressive symptoms may differ in severity and change over time in people living with HIV (PLWH). Describing depression trajectories and associated clinical characteristics of PLWH in an interventional study may help in developing a more personalized medicine approach. Using latent class growth analysis four, 15-month self-reported depression trajectories were identified in 416 PLWH participating in a collaborative care program. The four subgroups were characterized by improving (58.4% [of participants]), worsening (9.4%), highly responsive (19.5%) and persistently severe (12.7%) depressive symptoms. A high proportion of individuals were in trajectories marked by improvement. Further, the highly responsive group had on average, over 50% reduction of self-reported depressive symptoms. Self-reported trauma, posttraumatic stress disorder, lower neighborhood-level education and fewer HIV and psychiatry clinic visits were associated with worsening or persistently severe depressive symptom trajectories. Members of the persistently severe group were less likely to be virally suppressed after 12-months. Identifying subgroups of PLWH based on changes in self-reported depressive symptoms may further inform intervention approaches that can advance care.
Keyphrases
- depressive symptoms
- quality improvement
- social support
- healthcare
- sleep quality
- posttraumatic stress disorder
- palliative care
- early onset
- bipolar disorder
- randomized controlled trial
- primary care
- human immunodeficiency virus
- hiv infected
- stress induced
- pain management
- cancer therapy
- hepatitis c virus
- affordable care act
- drug induced
- hiv testing
- data analysis