Abstract

Antiretroviral therapy dramatically reduces mortality in HIV+ individuals, and poor adherence to medication is the major barrier to successful treatment. While there are several patient characteristics associated with non-adherence, depression is an easily identifiable and predictably modifiable barrier to adherence across several diseases. We propose a non-blinded randomized controlled trial to test the efficacy of antidepressant therapy to improve use of and adherence to antiretroviral drug therapy among HIV+ homeless and marginally housed depressed persons. The intervention group will receive antidepressant therapy at a storefront project site and the control group will be referred to standard mental health services in the community. We will examine five primary aims, including depression treatment, adherence to antiretroviral therapy, duration of sustained antiretroviral treatment, initiation of treatment, and viral suppression.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH063011-04
Application #
6795443
Study Section
Special Emphasis Panel (ZRG1-AARR-8 (01))
Program Officer
Stoff, David M
Project Start
2001-09-30
Project End
2006-08-31
Budget Start
2004-09-01
Budget End
2006-08-31
Support Year
4
Fiscal Year
2004
Total Cost
$607,885
Indirect Cost

  Institution

Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143

  Publications

Grelotti, David J; Hammer, Gwendolyn P; Dilley, James W et al. (2017) Does substance use compromise depression treatment in persons with HIV? Findings from a randomized controlled trial. AIDS Care 29:273-279
Tsai, Alexander C; Mimiaga, Matthew J; Dilley, James W et al. (2013) Does effective depression treatment alone reduce secondary HIV transmission risk? Equivocal findings from a randomized controlled trial. AIDS Behav 17:2765-72
Tsai, Alexander C; Karasic, Dan H; Hammer, Gwendolyn P et al. (2013) Directly observed antidepressant medication treatment and HIV outcomes among homeless and marginally housed HIV-positive adults: a randomized controlled trial. Am J Public Health 103:308-15
Tsai, Alexander C; Weiser, Sheri D; Petersen, Maya L et al. (2010) A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV. Arch Gen Psychiatry 67:1282-90
Thompson, Vanessa V; Ragland, Kathleen E; Hall, Christopher S et al. (2005) Provider assessment of eligibility for hepatitis C treatment in HIV-infected homeless and marginally housed persons. AIDS 19 Suppl 3:S208-14
Weiser, Sheri D; Wolfe, William R; Bangsberg, David R (2004) The HIV epidemic among individuals with mental illness in the United States. Curr HIV/AIDS Rep 1:186-92
Liechty, Cheryl A; Alexander, Christopher S; Harrigan, P Richard et al. (2004) Are untimed antiretroviral drug levels useful predictors of adherence behavior? AIDS 18:127-9
Riley, Elise D; Wu, Albert W; Perry, Sharon et al. (2003) Depression and drug use impact health status among marginally housed HIV-infected individuals. AIDS Patient Care STDS 17:401-6
Bangsberg, David R; Bronstone, Amy; Chesney, Margaret A et al. (2002) Computer-assisted self-interviewing (CASI) to improve provider assessment of adherence in routine clinical practice. J Acquir Immune Defic Syndr 31 Suppl 3:S107-11