ArticleArchives of general psychiatry2010
A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV.
Article in Archives of general psychiatry, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
80 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Reliability and validity of depression assessment among persons with HIV in sub-Saharan Africa: systematic review and meta-analysis.Journal of acquired immune deficiency syndromes (1999) · 2014Pooled it
- Depression treatment enhances adherence to antiretroviral therapy: a meta-analysis.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2014Pooled it
- Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis.Journal of the International AIDS Society · 2013Pooled it
- The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review.AIDS and behavior · 2012Pooled it
- Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel.Annals of internal medicine · 2012Guideline
- Long-Term Effect of Group Support Psychotherapy on Depression and HIV Treatment Outcomes: Secondary Analysis of a Cluster Randomized Trial in Uganda.Psychosomatic medicine · 2022Trial
- Does substance use compromise depression treatment in persons with HIV? Findings from a randomized controlled trial.AIDS care · 2017Trial
- The effect of antidepressant treatment on HIV and depression outcomes: results from a randomized trial.AIDS (London, England) · 2015Trial
- Event-level relationship between methamphetamine use significantly associated with non-adherence to pharmacologic trial medications in event-level analyses.Drug and alcohol dependence · 2014Trial
- Does effective depression treatment alone reduce secondary HIV transmission risk? Equivocal findings from a randomized controlled trial.AIDS and behavior · 2013Trial
- Directly observed antidepressant medication treatment and HIV outcomes among homeless and marginally housed HIV-positive adults: a randomized controlled trial.American journal of public health · 2013Trial
- Assessing the effect of Measurement-Based Care depression treatment on HIV medication adherence and health outcomes: rationale and design of the SLAM DUNC Study.Contemporary clinical trials · 2012Trial
- Could antidepressants increase mood and immunity at the same time?Frontiers in psychiatry · 2025Review
- Derivation of a multivariate longitudinal causal effects model.Journal of applied statistics · 2025Article
- Current Challenges, Solutions, and Novel Directions in Research and Clinical Care: Proceedings From the 14th Annual International Workshop on HIV and Aging.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- A marginal structural model to estimate the effect of antidepressant medication treatment on major cardiovascular events among people with post-traumatic stress disorder.Psychological medicine · 2023Article
- The comorbidity of depression and neurocognitive disorder in persons with HIV infection: call for investigation and treatment.Frontiers in cellular neuroscience · 2023Article
- Internalized stigma, depressive symptoms, and the modifying role of antiretroviral therapy: A cohort study in rural Uganda.SSM. Mental health · 2021Article
- Interventions Addressing Depression and HIV-Related Outcomes in People with HIV.Current HIV/AIDS reports · 2021Review
- Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda.Journal of affective disorders reports · 2021Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
contextDepression strongly predicts nonadherence to human immunodeficiency virus (HIV) antiretroviral therapy, and adherence is essential to maintaining viral suppression. This suggests that pharmacologic treatment of depression may improve virologic outcomes. However, previous longitudinal observational analyses have inadequately adjusted for time-varying confounding by depression severity, which could yield biased estimates of treatment effect. Application of marginal structural modeling to longitudinal observation data can, under certain assumptions, approximate the findings of a randomized controlled trial.
objectiveTo determine whether antidepressant medication treatment increases the probability of HIV viral suppression.
designCommunity-based prospective cohort study with assessments conducted every 3 months.
settingCommunity-based research field site in San Francisco, California.
participantsOne hundred fifty-eight homeless and marginally housed persons with HIV who met baseline immunologic (CD4+ T-lymphocyte count, <350/μL) and psychiatric (Beck Depression Inventory II score, >13) inclusion criteria, observed from April 2002 through August 2007.
main outcome measuresProbability of achieving viral suppression to less than 50 copies/mL. Secondary outcomes of interest were probability of being on an antiretroviral therapy regimen, 7-day self-reported percentage adherence to antiretroviral therapy, and probability of reporting complete (100%) adherence.
resultsMarginal structural models estimated a 2.03 greater odds of achieving viral suppression (95% confidence interval [CI], 1.15-3.58; P = .02) resulting from antidepressant medication treatment. In addition, antidepressant medication use increased the probability of antiretroviral uptake (weighted odds ratio, 3.87; 95% CI, 1.98-7.58; P < .001). Self-reported adherence to antiretroviral therapy increased by 25 percentage points (95% CI, 14-36; P < .001), and the odds of reporting complete adherence nearly doubled (weighted odds ratio, 1.94; 95% CI, 1.20-3.13; P = .006).
conclusionsAntidepressant medication treatment increases viral suppression among persons with HIV. This effect is likely attributable to improved adherence to a continuum of HIV care, including increased uptake and adherence to antiretroviral therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.