Depressive Symptoms at HIV Testing and Two-Year All-Cause Mortality Among Men Who Inject Drugs in Vietnam

Abstract

People who inject drugs (PWID) with HIV experience an elevated risk of death. A potentially important determinant of survival is the high burden of depression. This study examined the relationship of depressive symptoms at HIV testing with 2-year all-cause mortality among newly diagnosed HIV-positive PWID in Vietnam. At HIV testing, 141 PWID (42%) experienced severe depressive symptoms, and over the 2 years following diagnosis, 82 PWID (24%) died. Controlling for potential confounders, the 2-year risk of death among those with depressive symptoms was 9.7% (95% CI - 1.2, 20.6%) higher than the risk among those without depressive symptoms. This increased risk of mortality for PWID with depressive symptoms was relatively consistent throughout the 2-year period: at 6, 12, and 18 months, the risk difference was 12.6% (5.5-19.7%), 13.9% (4.6-23.2%), and 11.0% (0.9-21.1%), respectively. HIV diagnosis may provide an important opportunity for depression screening and treatment, subsequently improving survival in this key population.Trial registry: ClinicalTrials.gov NCT01689545.

Keywords: Depression; HIV; Injection drug use; Mortality; Vietnam.

Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1.

Weighted cumulative risk of death (with 95% CI) by baseline depression (at HIV testing) at 6, 12, 18, and 24 months after HIV diagnosis for 336 PWID in Vietnam.

Figure 2.

Crude and weighted cumulative RDs (with 95% CI) for mortality at 6, 12, 18, and 24 months after HIV diagnosis, comparing PWID with and without depressive symptoms at HIV testing.