When "need plus supply" does not equal demand: challenges in uptake of depression treatment in HIV clinical care

Psychiatr Serv. 2015 Mar 1;66(3):321-3. doi: 10.1176/appi.ps.201400132. Epub 2014 Dec 1.


Objective: Depression is common among patients in HIV care and is associated with worse HIV-related health behaviors and outcomes. Effective depression treatment is available, yet depression remains widely underdiagnosed and undertreated in HIV care.

Methods: As part of a multisite, randomized trial of depression treatment in HIV clinical care, the proportion of positive depression screens that resulted in study enrollment and reasons for nonenrollment were examined.

Results: Over 33 months, patients completed 9,765 depression screens; 19% were positive for depression, and of these 88% were assessed for study eligibility. Of assessed positive screens, 11% resulted in study enrollment. Nonenrollment after a positive screen was sometimes dictated by the study eligibility criteria, but it was often related to potentially modifiable provider- or patient-level barriers.

Conclusions: Addressing patient- and provider-level barriers to engaging in depression treatment will be critical to maximize the reach of depression treatment services for HIV patients.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Depressive Disorder / complications*
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • HIV Infections / complications*
  • HIV Infections / psychology
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Socioeconomic Factors