Incidence and Impact of Posttraumatic Stress Disorder and Comorbid Depression on Adherence to HAART and CD4⁺Counts in People Living with HIV

Abstract

Recent research suggests that the presence of posttraumatic stress disorder (PTSD) and depressive symptoms is independently related to abnormal hormone levels, inadequate medication adherence, and faster HIV disease progression. Although PTSD and depression occur comorbidly at high rates, the impact of both disorders on adherence and disease progression has not been examined. The present study examined the impact of PTSD and comorbid depression on CD4 cell counts and medication adherence in 58 male and 11 female (36% African American) HIV-positive individuals recruited from an AIDS service organization. Results revealed that participants high in depressive symptoms had lower CD4 cell counts and were less likely to adhere to their medication regimens than participants high in PTSD symptoms and those high in comorbid symptomatology. The present results suggest that the presence of depressive symptoms may be responsible for the observed impact of PTSD on people living with HIV (PLWH), and that failure to examine comorbid disorders may not adequately address the impact of clinical symptoms on people living with HIV.

Antidepressant Treatment and Adherence to Combination Antiretroviral Therapy among Patients with AIDS and Diagnosed Depression

“…[13]. Recently, this pattern of association has also been found in studies of adherence that include biological measures associated with lower adherence, such as lower CD4 count [14] and detectable viral load [15].…”

HIV/AIDS-related stigma in Kumasi, Ghana

“…Ironically, this secrecy hinders uptake of treatment and of support services that can be provided by family members (Mill 2003). People who feel stigmatized or discriminated against are more likely to have poor health outcomes, socio-psychological problems, and suicidal thoughts , Reynolds, et al 2004, Bottonari, et al 2005, Katz and Nevid 2005, Sledjeski, et al 2005. Tackling HIV stigma will involve tackling perceptions and values towards sexuality and HIV/AIDS.…”

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

“…For example, researchers have found that depression (Ammassari et al 2004;Kleeberger et al 2004;Sledjeski et al 2005) and low self-efficacy (Catz et al 2000;Godin et al 2005) contribute to low levels of reported adherence, and that having a good support system and positive attitudes (Catz et al 2000;Godin et al 2005) about medication taking foster adherence. While HIV adherence literature provides a good understanding of the personal and social variables that are most likely to play a role in ART adherence, the complexity of the interrelationships among these variables may be less well understood.…”