Combination antiretroviral therapy and improvements in mental health: results from a nationally representative sample of persons undergoing care for HIV in the United States

J Acquir Immune Defic Syndr. 2003 May 1;33(1):104-11. doi: 10.1097/00126334-200305010-00015.

Abstract

Objective: To test whether mental health improvements observed in a nationally representative sample of 2466 HIV+ persons receiving care in the United States during the dissemination of combination antiretroviral therapy (ART) is a result of global optimism or directly related to treatment.

Analysis: Data were analyzed by means of a linear regression model of the change in psychiatric symptoms from baseline (January 1996-April 1997) to the first follow-up interview approximately 8 months later as a function of changes in CD4+ counts, opportunistic infection treatments, and HIV physical symptoms in the overall sample and separately in participants who maintained ART, initiated ART, never received ART, or transitioned to a less recommended regimen during the study period.

Results: The reduction in psychiatric symptoms was comparable across all treatment groups (p >.05), suggesting a global effect. In patients who initiated or maintained ART, fewer psychiatric symptoms were significantly related to higher CD4+ and fewer opportunistic infection treatments and HIV symptoms, however, suggesting a treatment effect.

Conclusion: ART appears to be responsible for both a treatment-specific and global improvement in the mental health of HIV+ patients, possibly through the promise of extended survival and a better quality of life.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • HIV Infections / physiopathology
  • Humans
  • Male
  • Mental Disorders / complications*
  • Mental Disorders / drug therapy*
  • Mental Disorders / physiopathology
  • United States

Substances

  • Anti-HIV Agents