Estimating the Effect of Depression on HIV Transmission Risk Behaviors Among People Who Inject Drugs in Vietnam: A Causal Approach

Sara N. Levintow; Brian W. Pence; Kimberly A. Powers; Teerada Sripaipan; Tran Viet Ha; Viet Anh Chu; Vu Minh Quan; Carl A. Latkin; Vivian Go

doi:10.1007/s10461-020-03007-9

Estimating the Effect of Depression on HIV Transmission Risk Behaviors Among People Who Inject Drugs in Vietnam: A Causal Approach

Sara N. Levintow, Brian W. Pence, Kimberly A. Powers, Teerada Sripaipan, Tran Viet Ha, Viet Anh Chu, Vu Minh Quan, Carl A. Latkin, Vivian Go

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

The burden of depression and HIV is high among people who inject drugs (PWID), yet the effect of depression on transmission risk behaviors is not well understood in this population. Using causal inference methods, we analyzed data from 455 PWID living with HIV in Vietnam 2009–2013. Study visits every 6 months over 2 years measured depressive symptoms in the past week and injecting and sexual behaviors in the prior 3 months. Severe depressive symptoms (vs. mild/no symptoms) increased injection equipment sharing (risk difference [RD] = 3.9 percentage points, 95% CI −1.7, 9.6) but not condomless sex (RD = −1.8, 95% CI −6.4, 2.8) as reported 6 months later. The cross-sectional association with injection equipment sharing at the same visit (RD = 6.2, 95% CI 1.4, 11.0) was stronger than the longitudinal effect. Interventions on depression among PWID may decrease sharing of injection equipment and the corresponding risk of HIV transmission. Clinical trial registration ClinicalTrials.gov NCT01689545.

Original language	English (US)
Pages (from-to)	438-446
Number of pages	9
Journal	AIDS and behavior
Volume	25
Issue number	2
DOIs	https://doi.org/10.1007/s10461-020-03007-9
State	Published - Feb 2021

Keywords

Depressive symptoms
HIV transmission
Injecting behavior
Marginal structural models
People who inject drugs
Sexual behavior

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1007/s10461-020-03007-9

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title = "Estimating the Effect of Depression on HIV Transmission Risk Behaviors Among People Who Inject Drugs in Vietnam: A Causal Approach",

abstract = "The burden of depression and HIV is high among people who inject drugs (PWID), yet the effect of depression on transmission risk behaviors is not well understood in this population. Using causal inference methods, we analyzed data from 455 PWID living with HIV in Vietnam 2009–2013. Study visits every 6 months over 2 years measured depressive symptoms in the past week and injecting and sexual behaviors in the prior 3 months. Severe depressive symptoms (vs. mild/no symptoms) increased injection equipment sharing (risk difference [RD] = 3.9 percentage points, 95% CI −1.7, 9.6) but not condomless sex (RD = −1.8, 95% CI −6.4, 2.8) as reported 6 months later. The cross-sectional association with injection equipment sharing at the same visit (RD = 6.2, 95% CI 1.4, 11.0) was stronger than the longitudinal effect. Interventions on depression among PWID may decrease sharing of injection equipment and the corresponding risk of HIV transmission. Clinical trial registration ClinicalTrials.gov NCT01689545.",

keywords = "Depressive symptoms, HIV transmission, Injecting behavior, Marginal structural models, People who inject drugs, Sexual behavior",

author = "Levintow, {Sara N.} and Pence, {Brian W.} and Powers, {Kimberly A.} and Teerada Sripaipan and Ha, {Tran Viet} and Chu, {Viet Anh} and Quan, {Vu Minh} and Latkin, {Carl A.} and Vivian Go",

note = "Funding Information: Doctoral training support for Sara N. Levintow was provided by NIDA (R36 DA045569), NIAID (T32 AI070114-10), and ViiV Healthcare (pre-doctoral fellowship). The parent trial for this study was funded by NIDA (R01 DA022962-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Acknowledgements Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2021",

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doi = "10.1007/s10461-020-03007-9",

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T2 - A Causal Approach

AU - Levintow, Sara N.

AU - Pence, Brian W.

AU - Powers, Kimberly A.

AU - Sripaipan, Teerada

AU - Ha, Tran Viet

AU - Chu, Viet Anh

AU - Quan, Vu Minh

AU - Latkin, Carl A.

AU - Go, Vivian

N1 - Funding Information: Doctoral training support for Sara N. Levintow was provided by NIDA (R36 DA045569), NIAID (T32 AI070114-10), and ViiV Healthcare (pre-doctoral fellowship). The parent trial for this study was funded by NIDA (R01 DA022962-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Acknowledgements Publisher Copyright: © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

PY - 2021/2

Y1 - 2021/2

N2 - The burden of depression and HIV is high among people who inject drugs (PWID), yet the effect of depression on transmission risk behaviors is not well understood in this population. Using causal inference methods, we analyzed data from 455 PWID living with HIV in Vietnam 2009–2013. Study visits every 6 months over 2 years measured depressive symptoms in the past week and injecting and sexual behaviors in the prior 3 months. Severe depressive symptoms (vs. mild/no symptoms) increased injection equipment sharing (risk difference [RD] = 3.9 percentage points, 95% CI −1.7, 9.6) but not condomless sex (RD = −1.8, 95% CI −6.4, 2.8) as reported 6 months later. The cross-sectional association with injection equipment sharing at the same visit (RD = 6.2, 95% CI 1.4, 11.0) was stronger than the longitudinal effect. Interventions on depression among PWID may decrease sharing of injection equipment and the corresponding risk of HIV transmission. Clinical trial registration ClinicalTrials.gov NCT01689545.

AB - The burden of depression and HIV is high among people who inject drugs (PWID), yet the effect of depression on transmission risk behaviors is not well understood in this population. Using causal inference methods, we analyzed data from 455 PWID living with HIV in Vietnam 2009–2013. Study visits every 6 months over 2 years measured depressive symptoms in the past week and injecting and sexual behaviors in the prior 3 months. Severe depressive symptoms (vs. mild/no symptoms) increased injection equipment sharing (risk difference [RD] = 3.9 percentage points, 95% CI −1.7, 9.6) but not condomless sex (RD = −1.8, 95% CI −6.4, 2.8) as reported 6 months later. The cross-sectional association with injection equipment sharing at the same visit (RD = 6.2, 95% CI 1.4, 11.0) was stronger than the longitudinal effect. Interventions on depression among PWID may decrease sharing of injection equipment and the corresponding risk of HIV transmission. Clinical trial registration ClinicalTrials.gov NCT01689545.

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KW - People who inject drugs

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Estimating the Effect of Depression on HIV Transmission Risk Behaviors Among People Who Inject Drugs in Vietnam: A Causal Approach

Abstract

Keywords

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