ArticleAIDS and behavior2019
The Depression Treatment Cascade: Disparities by Alcohol Use, Drug Use, and Panic Symptoms Among Patients in Routine HIV Care in the United States.
Article in AIDS and behavior, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 22 citations in OpenAlex.
- Sociodemographic and HIV-Related Characteristics Associated with Mental Health Diagnoses Among People Living with HIV.AIDS and behavior · 2026Article
- Forecasting multimorbidity in aging people with HIV using a microsimulation model.Communications health · 2026Article
- Sociodemographic and clinical factors associated with use of depression treatment among people with HIV in the United States: An electronic health records-based cohort study.Journal of affective disorders · 2025Article
- Changes in the Prevalence of Non-AIDS Conditions Among Hospitalized Persons With HIV in the United States and Canada, 2008-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Understanding depression and the PHQ-9 items among people living with HIV: A multiple methods qualitative study in Yaoundé, Cameroon.SSM. Mental health · 2024Article
- Integrating a mental health intervention into PrEP services for South African young women: a human-centred implementation research approach to intervention development.Journal of the International AIDS Society · 2024Article
- Specialty Care Referral for Underrepresented Minorities Living with HIV in the United States: Experiences, Barriers, and Facilitators.AIDS patient care and STDs · 2024Article
- Prevalence of Diagnosed and Undiagnosed Depression Among US Adults with Human Immunodeficiency Virus: Data from the Medical Monitoring Project.AIDS patient care and STDs · 2024Article
- Depression and Anxiety Symptoms and Treatment Utilization, and Associated HIV Outcomes among Adults with HIV in Rural Florida.AIDS and behavior · 2024Article
- Racial, ethnic, and age disparities in the association of mental health symptoms and polysubstance use among persons in HIV care.PloS one · 2023Article
- A retrospective analysis of the care cascades for non-communicable disease and mental health among people living with HIV at a tertiary-care centre in Malaysia: opportunities to identify gaps and optimize care.Journal of the International AIDS Society · 2020Article
- A call to action: strengthening the capacity for data capture and computational modelling of HIV integrated care in low- and middle-income countries.Journal of the International AIDS Society · 2020Article
- Patient-level predictors of detection of depressive symptoms, referral, and uptake of depression counseling among chronic care patients in KwaZulu-Natal, South Africa.Global mental health (Cambridge, England) · 2020Article
- Dopaminergic impact of cART and anti-depressants on HIV neuropathogenesis in older adults.Brain research · 2019Review
- Operationalizing a Behavioral Health Services Cascade of Care Model: Lessons Learned from a 33-Site Implementation in Juvenile Justice Community Supervision.Federal probation · 2019Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
Little is known about disparities in depression prevalence, treatment, and remission by psychiatric comorbidities and substance use among persons living with HIV (PLWH). We conducted a cross-sectional analysis in a large cohort of PLWH in routine care and analyzed conditional probabilities of having an indication for depression treatment, receiving treatment, receiving indicated treatment adjustments, and achieving remission, stratified by alcohol use, illicit drug use, and panic symptoms. Overall, 34.7% (95% CI 33.9-35.5%) of participants had an indication for depression treatment and of these, 55.3% (53.8-56.8%) were receiving antidepressants. Among patients receiving antidepressants, 33.0% (31.1-34.9%) had evidence of remitted depression. In a subsample of sites with antidepressant dosage data, only 8.8% (6.7-11.5%) of patients received an indicated treatment adjustment. Current drug users (45.8%, 95% CI 43.6-48.1%) and patients reporting full symptoms of panic disorder (75.0%, 95% CI 72.9-77.1%) were most likely to have an indication for antidepressant treatment, least likely to receive treatment given an indication (current drug use: 47.6%, 95% CI 44.3-51.0%; full panic symptoms: 50.8%, 95% CI 48.0-53.6%), or have evidence of remitted depression when treated (22.3%, 95% CI 18.5-26.6%; and 7.3%, 95% CI 5.5-9.6%, respectively). In a multivariable model, drug use and panic symptoms were independently associated with poorer outcomes along the depression treatment cascade. Few differences were evident by alcohol use. Current drug users were most likely to have an indication for depression treatment, but were least likely to be receiving treatment or to have remitted depression. These same disparities were even more starkly evident among patients with co-occurring symptoms of panic disorder compared to those without. Achieving improvements in the depression treatment cascade will likely require attention to substance use and psychiatric comorbidities.
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