Factors Associated with Mood Disorder Diagnosis Among a Population Based Cohort of Men and Women Living With and Without HIV in British Columbia Between 1998 and 2012

Abstract

Using data from the Comparison of Outcomes and Service Utilization Trends (COAST) study we examined factors associated with mood disorder diagnosis (MDD) among people living with HIV (PLHIV) and HIV-negative individuals in British Columbia, Canada. MDD cases were identified between 1998 and 2012 using International Classification of Disease 9 and 10 codes. A total of 491,796 individuals were included and 1552 (23.7%) and 60,097 (12.4%) cases of MDD were identified among the HIV-positive and HIV-negative populations, respectively. Results showed HIV status was associated with greater odds of MDD among men and lower odds among women. Among PLHIV, MDD was significantly associated with: identifying as gay, bisexual or other men who have sex with men compared to heterosexuals; higher viral load; history of injection drug use; and concurrent anxiety, dysthymia, and substance use disorders. Findings highlight the need for comprehensive and holistic HIV and mental health care.

HIV and Sexual Dysfunction in Men

“…Second, anxiety associated to the guilt and fear of transmitting the disease through sexual activity could have a huge impact on intimate relationships, and hence on erectile function [45]. Higher depression scores in HIV-infected patients were associated with sexual habits (MSM compared to heterosexual men), higher viral load and history of substance abuse [125]. Therefore, poor emotional status should always be contemplated in this setting of patients, since they present major risk factor in the development sexual dysfunction [97].…”

Cohort profile: the Comparative Outcomes And Service Utilization Trends (COAST) Study among people living with and without HIV in British Columbia, Canada

“…More recently, another publication by our group presented evidence demonstrating higher rates of mood disorder diagnosis among HIV-positive individuals compared with the general population. 32 These publications using the COAST Study data, including several others in development, will provide additional understanding around these topics and contribute to important gaps in the literature.…”

Correlates of opioid and benzodiazepine co-prescription among people living with HIV in British Columbia, Canada: A population-level cohort study

“…First, administrative data was utilized, and as such, certain diagnoses including psychiatric disorders or SUD may have been undetected, and thus not captured, or been inappropriately coded. However, the definitions we used have been previously used in other published studies (Closson et al, 2017). Second, our study did not capture the illicit use of opioids or benzodiazepines as the PharmaNet database only captures opioids and benzodiazepines that are prescribed (British Columbia Ministry of Health, 2014).…”

“…The main explanatory variables of interest were: sex (female vs male); age (per 10-year increase); calendar year (per year increase); depression diagnosis based on ICD-9/10 codes derived from MSP and DAD; anxiety diagnosis based on ICD-9/10 codes derived from MSP and DAD; substance use disorder based on ICD-9/10 codes derived from MSP and DAD, a prescription of methadone or buprenorphine/naloxone derived from Pharmanet, or identification as a high-risk group derived from the BC Centre for Disease Control or BC Centre for Excellence in HIV/AIDS databases (Closson et al, 2017); Charlson comorbidity index (CCI; per unit increase) derived from MSP and DAD; CD4 cell count (per 100 cells/mL increase) derived from the BC Centre for Excellence in HIV/AIDS database; and viral load (per log 10 increase) derived from the BC Centre for Excellence in HIV/AIDS database.…”