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Brief report: Factors associated with depression among homeless and marginally housed HIV-infected men in San Francisco

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Abstract

OBJECTIVES: To evaluate the prevalence of and factors associated with depression among HIV-infected homeless and marginally housed men.

DESIGN: Cross-sectional study.

PARTICIPANTS AND SETTING: Homeless and marginally housed men living with HIV in San Francisco identified from the Research on Access to Care in the Homeless (REACH) Cohort.

MEASUREMENTS: The primary outcome was symptoms of depression, as measured by the Beck Depression Inventory (BDI). Multivariate logistic regression was used to identify associations of sociodemographic characteristics, drug and alcohol use, housing status, jail status, having a representative payee, health care utilization, and CD4 T lymphocyte counts.

RESULTS: Among 239 men, 134 (56%) respondents screened positive for depression. Variables associated with depression in multivariate analysis included white race (adjusted odds ratio [AOR]=2.2. confidence interval [CI]=1.3 to 3.9), having a representative payee (AOR=2.4, CI=1.3 to 4.2), heavy alcohol consumption (AOR=4.7, CI=1.3 to 17.1), and recently missed medical appointments (AOR=2.6, CI=1.4 to 4.8).

CONCLUSIONS: Depression is a major comorbidity among the HIV-infected urban poor. Given that missed medical appointments and alcohol use are likely indicators of depression and contributors to continued depression, alternate points of contact are necessary with many homeless individuals. Providers may consider partnering with payees to improve follow-up with individuals who are HIV-positive, homeless, and depressed.

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References

  1. Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58:721–8.

    Article  PubMed  CAS  Google Scholar 

  2. Asch SM, Kilbourne AM, Gifford AL, et al. Underdiagnosis of depression in HIV: who are we missing? J Gen Intern Med. 2003;18:450–6.

    Article  PubMed  Google Scholar 

  3. Riley ED, Bangsberg DR, Perry S, Clark RA, Moss AR, Wu AW. Reliability and validity of the SF-36 in HIV-infected homeless and marginally housed individuals. Qual Life Res. 2003;12:1051–8.

    Article  PubMed  CAS  Google Scholar 

  4. Evans JD, Wright DE, Svanum S, Bond GR. Psychiatric disorder and unmet service needs among welfare clients in a representative payee program. Community Ment Health J. 2004;40:539–48.

    Article  PubMed  Google Scholar 

  5. Ickovics J, Hamburger M, Vlahov D, et al. Mortality, CD4 count decline and depressive symptoms among HIV-seropositive women. Longitudinal analysis from the HIV Epidemiology Research Study. JAMA. 2001;285:1466–74.

    Article  PubMed  CAS  Google Scholar 

  6. Mayne TJ, Vittinghoff E, Chesney MA, Barrett DC, Coates TJ. Depressive affect and survival among gay and bisexual men infected with HIV. Arch Intern Med. 1996;156:2233–8.

    Article  PubMed  CAS  Google Scholar 

  7. Page-Shafer K, Delorenze GN, Satariano WA, Winkelstein W, Jr. Comorbidity and survival in HIV-infected men in the San Francisco Men’s Health Survey. Ann Epidemiol. 1996;6:420–3.

    Article  PubMed  CAS  Google Scholar 

  8. Cordillo V, Del Amo J, Soriano V, et al. Sociodemographic and psychological variables influencing adherence to antiretroviral therapy. AIDS. 1999;13:1763–9.

    Article  Google Scholar 

  9. Tucker JS, Burnam MA, Sherbourne CD, Kung FY, Gifford AL. Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with human immunodeficiency virus infection. Am J Med. 2003;114:573–80.

    Article  PubMed  Google Scholar 

  10. Cook JA, Cohen MH, Burke J, et al. Effects of depressive symptoms and mental health quality of life on use of highly active antiretroviral therapy among HIV-seropositive women. J Acquir Immune Defic Syndr. 2002;30:401–9.

    PubMed  Google Scholar 

  11. Katz MH, Douglas JM, Jr., Bolan GA, et al. Depression and use of mental health services among HIV-infected men. AIDS Care. 1996;8:433–42.

    Article  PubMed  CAS  Google Scholar 

  12. Sambamoorthi U, Walkup J, Olfson M, Crystal S. Antidepressant treatment and health services utilization among HIV-infected medicaid patients diagnosed with depression. J Gen Intern Med. 2000;15:311–20.

    Article  PubMed  CAS  Google Scholar 

  13. Turner BJ, Laine C, Cosler L, Hauck WW. Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. J Gen Intern Med. 2003;18:248–57.

    Article  PubMed  Google Scholar 

  14. Zolopa AR, Hahn JA, Gorter R, et al. HIV and tuberculosis infection in San Francisco’s homeless adults. Prevalence and risk factors in a representative sample. JAMA. 1994;272:455–61.

    Article  PubMed  CAS  Google Scholar 

  15. Robertson MJ, Clark RA, Charlebois ED, et al. HIV seroprevalence among homeless and marginally housed adults in San Francisco. Am J Public Health. 2004;94:1207–1.

    Article  PubMed  Google Scholar 

  16. Munoz M, Vazquez C, Koegel P, Sanz J, Burnam MA. Differential patterns of mental disorders among the homeless in Madrid (Spain) and Los Angeles (USA). Soc Psychiatry Psychiatr Epidemiol. 1998;33:514–20.

    Article  PubMed  CAS  Google Scholar 

  17. La Gory M, Ritchey FJ, Mullis J. Depression among the homeless. J Health Soc Behav. 1990;31:87–102.

    Article  PubMed  Google Scholar 

  18. Beck A, Steer R, Brown G. Manual for Beck Depression Inventory-II. San Antonio, Tex: Psychological Corporation; 1996.

    Google Scholar 

  19. Storch EA, Roberti JW, Roth DA. Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory — Second Edition in a sample of college students. Depress Anxiety. 2004;19:187–9.

    Article  PubMed  Google Scholar 

  20. Sharp LK, Lipsky MS. Screening for depression across the lifespan: a review of measures for use in primary care settings. Am Fam Phys. 2002;66:1001–8.

    Google Scholar 

  21. Hosmer D, Lemeshow S. Applied Logistic Regression. New York: John Wiley & Sons; 1989.

    Google Scholar 

  22. Hibbs JR, Benner L, Klugman L, et al. Mortality in a cohort of homeless adults in Philadelphia. N Engl J Med. 1994;331:304–9.

    Article  PubMed  CAS  Google Scholar 

  23. Warheit GJ, Holzer CE, Arey SA III. Race and mental illness: an epidemiologic update. J Health Soc Behav. 1975;16:243–56.

    Article  PubMed  CAS  Google Scholar 

  24. Riolo SA, Nguyen TA, Greden JF, King CA. Prevalence of depression by race/ethnicity: findings from the National Health and Nutrition Examination Survey III. Am J Public Health. 2005;95:998–1000.

    Article  PubMed  Google Scholar 

  25. Sachs-Ericsson N, Plant EA, Blazer DG. Racial differences in the frequency of depressive symptoms among community dwelling elders: the role of socioeconomic factors. Aging Mental Health. 2005;9:201–9.

    Article  PubMed  CAS  Google Scholar 

  26. Rosen MI, Rosenheck RA, Shaner AL, Eckman TA, Gamache GR, Krebs CW. Substance abuse and the need for money management assistance among psychiatric inpatients. Drug Alcohol Depend. 2002;67:331–4.

    Article  PubMed  Google Scholar 

  27. Jones-Webb R, Jacobs DR, Jr., Flack JM, Liu K. Relationships between depressive symptoms, anxiety, alcohol consumption, and blood pressure: results from the CARDIA Study. Coronary Artery Risk Development in Young Adults Study. Alcohol Clin Exp Res. 1996;20:420–7.

    Article  PubMed  CAS  Google Scholar 

  28. Grant BF, Harford TC. Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey. Drug Alcohol Depend. 1995;39:197–206.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA

    Sheri D. Weiser MD, MPH

  2. Epidemiology and Prevention Interventions (EPI) Center, Division of Infectious Diseases, San Francisco General Hospital, UCSF, CA, USA

    Sheri D. Weiser MD, MPH, Elise D. Riley PhD, Kathleen Ragland PhD, Gwendolyn Hammer PhD & Richard Clark MPH

  3. Positive Health Program, San Francisco General Hospital, UCSF, CA, USA

    David R. Bangsberg MD, MPH

Authors
  1. Sheri D. Weiser MD, MPH
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  2. Elise D. Riley PhD
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  3. Kathleen Ragland PhD
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  4. Gwendolyn Hammer PhD
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  5. Richard Clark MPH
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  6. David R. Bangsberg MD, MPH
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Corresponding author

Correspondence to Sheri D. Weiser MD, MPH.

Additional information

The authors have no conflicts of interest to declare for this work.

The Epidemiology and Prevention Interventions Center, Positive Health Program, and Center for AIDS Prevention Studies are programs of the UCSF AIDS Research Institute.

Sponsorship: This study was funded by National Institutes of Health (NIH) grants MH54907, MH66654, MH64388, and T32 MH19105. Dr. Bangsberg receives support from The Doris Duke Charitable Foundation.

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Weiser, S.D., Riley, E.D., Ragland, K. et al. Brief report: Factors associated with depression among homeless and marginally housed HIV-infected men in San Francisco. J GEN INTERN MED 21, 61–64 (2006). https://doi.org/10.1111/j.1525-1497.2005.0282.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2005.0282.x

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