The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers

Drug Alcohol Depend. 2014 Jan 1;134:85-91. doi: 10.1016/j.drugalcdep.2013.09.014. Epub 2013 Sep 23.

Abstract

Background: Depressive symptoms have been linked to HIV progression through a number of biobehavioral mechanisms including increased alcohol use. Although research supports an association between alcohol use and depressive symptoms among HIV patients, there have been few studies that have examined whether depressive symptoms predict subsequent drinking, especially among heavy drinking HIV-infected patients.

Method: Heavy drinking Russian HIV-infected patients (n=700) were recruited from addiction and HIV care settings for a randomized controlled trial of a risk reduction intervention [HERMITAGE]. GEE overdispersed Poisson regression analyses were conducted to assess the association between depressive symptoms and alcohol consumption 6-months later.

Results: In adjusted analyses, depressive symptom severity was significantly associated with drinks per day (global p=.02). Compared to the non-depressed category, mild depressive symptoms were significantly associated with more drinks per day [IRR=1.55, (95% CI: 1.14, 2.09)], while moderate [IRR=1.14, (95% CI: 0.83, 1.56)] and severe [IRR=1.48, (95% CI: 0.93, 2.34)] depressive symptoms were not. Associations between depressive symptom severity and heavy drinking days were not statistically significant (global p=.19). Secondary analyses using the BDI-II screening threshold (BDI-II>14) and the BDI-II cognitive subscale suggested an association between depressive symptoms and drinks per day over time but not heavy episodic drinking.

Conclusions: Among heavy drinking HIV-infected patients, elevated depressive symptoms were associated with greater subsequent alcohol use. These findings suggest that depressive symptoms may be important to address in efforts to reduce alcohol-related risks among HIV-infected populations.

Keywords: Alcohol; BDI-II; Depression; HIV; Heavy drinking; Russia.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / prevention & control
  • Alcohol Drinking / psychology
  • Cohort Studies
  • Depression / epidemiology*
  • Depression / prevention & control
  • Depression / psychology
  • Female
  • Follow-Up Studies
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control
  • HIV Infections / psychology
  • Humans
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Russia / epidemiology
  • Secondary Prevention* / methods