Associations between Antiretroviral Drugs on Depressive Symptomatology in Homogenous Subgroups of Women with HIV

Dionna W. Williams, Yuliang Li, Raha Dastgheyb, Kathryn C. Fitzgerald, Pauline M. Maki, Amanda B. Spence, Deborah R. Gustafson, Joel Milam, Anjali Sharma, Adaora A. Adimora, Igho Ofotokun, Margaret A. Fischl, Deborah Konkle-Parker, Kathleen M. Weber, Yanxun Xu, Leah H. Rubin

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Antiretroviral therapy (ART) is inconsistently associated with depression. These associations may depend on factors such as biological sex, age, and health status. Identifying such factors may help optimize treatment of HIV and depression. We implemented a novel approach to examine interindividual variability in the association between ART agents and depressive symptoms. 3434 women living with HIV (WLWH) from the Women’s Interagency HIV Study (WIHS) were computationally divided into subgroups based on sociodemographic (e.g., age) and longitudinal (from 1995 to 2016) behavioral and clinical profiles (e.g., substance use, HIV RNA, CD4 counts). Five subgroups (n’s ranged from 482 to 802) were identified and characterized as those with: controlled HIV/vascular comorbidities; profound HIV legacy effects; younger women [<45 years of age] with hepatitis C; primarily 35–55 year olds; and poorly controlled HIV/substance use. Within each subgroup, we examined associations between ART agents used over the past 6 months and item-level depressive symptoms on the Center for Epidemiologic Studies Depression Scale. Tenofovir (4 of 5 subgroups) followed by efavirenz, emtricitabine, stavudine, lopinavir, etravirine, nelfinavir, ritonavir, and maraviroc were the most common agents associated with depressive symptoms, although the pattern and directionality varied by subgroup. For example, lopinavir was associated with fewer symptoms among the subgroup with a legacy HIV effect but more symptoms among the subgroup with well-controlled HIV/vascular comorbidities. Unexpectedly, dolutegravir and raltegravir were not associated with depressive symptoms among any subgroup. Findings underscore marked interindividual variability in ART agents on depression in WLWH. Sociodemographic, clinical, and behavioral factors are important determinants of the relationship between ART agents and depressive symptoms in WLWH. [Figure not available: see fulltext.]

Original languageEnglish (US)
Pages (from-to)181-194
Number of pages14
JournalJournal of Neuroimmune Pharmacology
Issue number1
StatePublished - Mar 2021


  • Antiretrovirals
  • Depression
  • HIV
  • Heterogeneity
  • Women

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Immunology and Allergy
  • Immunology
  • Pharmacology


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