Antidepressant Therapy Can Improve Adherence to Antiretroviral Regimens Among HIV-Infected and Depressed Patients

Abstract

Several strategies have been introduced to manage nonadherence to highly active antiretroviral therapy (HAART). Treatment with antidepressants may improve self-reported adherence. In this brief report, a small sample of HIV-depressed patients (n = 9) were treated for a 6-month period with antidepressants improving self-reported adherence based on the HAART scale (poor, good, satisfactory, and optimal). Before the antidepressant treatment, adherence was reported as "good" by 3 patients and "satisfactory" by 6 patients. After antidepressant therapy, adherence to antiretroviral regimes was statistically higher in HIV-depressed on treatment than in HIV-depressed patients not treated with antidepressants (P < 0.0001). We used chi2 test with a significance level at P < 0.05. Treating depression in HIV-infected patients may serve to improve adherence to HAART.

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

“…In a meta-analysis of the effects of depression and anxiety on patient adherence, depressed patients had three times the odds of noncompliance compared to non-depressed patients (DiMatteo et al 2000). The observation that depression is inversely associated with adherence suggests that treatment of depression may improve adherence to medications (Dalessandro et al 2007). The qualitative study however, did not identify depression as a significant factor for adherence.…”

Translation of a comprehensive health behavior intervention for women living with HIV: the SMART/EST Women's Program

“…6 % not yet engaging in or no intention of engaging in regular and moderate physical activity in the next 6 months), physical activity in the past month (60.6 % nonactive), unprotected vaginal sex (50.4 % reporting unprotect-ORIGINAL RESEARCH ed vaginal sex with a main partner in the past month), responsible drinking SOC (63.1 % not yet engaging in or have no intention of engaging in responsible drinking behavior in the next 6 months), street drug use SOC (66. 7 % not yet engaging in or have no intention of engaging in abstinence or harm reduction in the next 6 months), current frequency of smoking (56.0 % currently smoking), and tobacco quitting SOC (66.9 % have not quit or have no intention of quitting tobacco in the next 6 months or more).…”

“…Translation of behavioral interventions for people living with HIV/AIDS (PLWHAs) that addresses multiple risk behaviors is especially appropriate, as PLWHAs have been identified as being at increased risk of comorbid health conditions, such as cardiovascular and pulmonary diseases, depression, diabetes, and addiction [3,4]. In addition, psychiatric disorders have also been associated with decrements in essential health behaviors for PLWHAs (e.g., antiretroviral medication adherence [5][6][7][8][9] and medical appointment attendance [10,11]) and with poorer overall mental health and quality of life [12,13].…”

Prevalencia, factores de riesgo y manejo de la depresión en pacientes con infección por VIH: Revisión de la literatura

“…Al respecto, una condición básica para este éxito terapéutico, compartida por muy pocas otras enfermedades, es un cumplimiento extremo de la indicación medicamentosa (adherencia). Pequeños incumplimientos de esta adherencia, se asocian a fracaso terapéutico (pérdida de la capacidad de suprimir la replicación viral con la consiguiente progresión de la enfermedad), agravado por la pérdida de efectividad de los anti-retrovirales previamente usados (desarrollo de resistencia) 29,[34][35][36] . Entre los factores psico-sociales más importantes para la pérdida de adherencia están: la falta de una red de apoyo social, el abuso de sustancias y la depresión 23,28,29,[34][35][36][37][38][39] .…”