Depressive Symptoms, Substance Use, and HIV-Related High-Risk Behaviors Among Opioid-Dependent Individuals: Results From the Clinical Trials Network

Abstract

The sample included 343 opioid-dependent adults enrolled in two national multisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001-002). Opioid-dependent individuals were recruited from 12 sites across the United States from January 2001 to July 2002. We examined associations between depressive symptoms, co-occurring substance use (i.e. the use of substances other than opioids), and HIV-related sexual and injection risk behaviors. Data were collected using the Addiction Severity Index (ASI) and the HIV Risk Behavior Scale, and analyzed using linear regression. Depressive symptoms were associated with an increased level of injection risk behaviors, but were not associated with risky sexual behaviors. The co-occurring use of amphetamines also increased the likelihood of risky sexual behaviors. The study limitations and clinical implications are noted. The study was funded by the U.S. National Institute on Drug Abuse.

Substance Use, Depression and Sociodemographic Determinants of HIV Sexual Risk Behavior in Outpatient Substance Abuse Treatment Patients

“…This is a common finding (Pilowsky, Wu, Burchett, Blazer, & Ling, 2011) which may reflect two factors. One is: libido, and, therefore, impetus to engage in sexual risk behavior, may be reduced by depression.…”

“…For depression, commonly found in between one-third and one-half of substance users in outpatient substance abuse treatment [Nunes, Sullivan and Levin, 2004], findings related to sexual risk are mixed. Some research has emphasized the constricting effects of depression on sexual drive and behavior (Pilowsky, Wu, Burchett, Blazer, & Ling, 2011). Other research has observed that depressive passivity, resignation and pessimism may drive the individual to careless risk behavior [Khan et al, 2009)…”

Psychiatric correlates of injection risk behavior among young people who inject drugs.

“…A number of studies with methadone maintenance or other drug treatment patients (Camacho, et al, 1996; Kleinman, et al, 1994; Malow, et al, 1992; Metzger, et al, 1991; Perdue, et al, 2003; Pilowsky, et al, 2011; Woody, et al, 1997), and drug users not in treatment (Johnson, et al, 2003; Johnson, et al, 2002; Simpson, et al, 1993; Strathdee, et al, 1997), including syringe exchange program participants (Kidorf, et al, 2010), have found that symptoms of psychological distress or dysfunction, particularly symptoms of depression, are associated with injection risk behavior, including sharing syringes and other equipment, number of sharing partners, sharing with strangers, and sharing with a person known to be HIV-positive.…”

Prevalence of depressive symptoms and associated factors among people who inject drugs in China

“…In particular, depression is a well-known antecedent of suicidal ideation among PWID (Armstrong et al, 2014;Jin et al, 2013). The prevalence of depression among PWID ranged from 25% to 84% in the USA, Canada, Australia, and India (Armstrong et al, 2013b;Callaly et al, 2001;Conner et al, 2008;Heimer et al, 2014;Mackesy-Amiti et al, 2012;Pilowsky et al, 2011;Springer, 2012;Teesson et al, 2005). In China, it ranged from 75.3% to 92.4% (Gu et al, 2010) and was even higher among PLWH (Sun et al, 2014;Wang et al, 2014).…”