Injection drug use, depression, and HIV screening in rural primary care settings: A retrospective cross-sectional study

Author:

Cody Shameka1,Albright David L1ORCID,McDaniel Justin2,McIntosh Shanna1

Affiliation:

1. The University of Alabama, USA

2. Southern Illinois University System, USA

Abstract

Introduction Antiretroviral therapy (ART) has reduced HIV viral replication and transmission of disease. However, continuing incidence of new HIV infections has been attributed to undiagnosed HIV infections among injection drug users. This purpose of this retrospective cross-sectional study was to determine whether depression moderates the relationship between injection drug use and HIV screening among people with substance use in the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program. Methods Electronic health record data were obtained from three consenting medical facilities (n = 103). Multivariable logistic regression analysis was conducted to determine the moderating effect of depression on the relationship between injection drug use and HIV screening. Results Bivariate analyses revealed that HIV screening was more common among individuals not engaged in injection drug use, 75% and 57% respectively. Participants who had never been screened had worse depressive symptoms on the PHQ-2 (M = 3.00, SE = 0.42) than individuals who had been screened for HIV (M = 1.45, SE = 0.17). After controlling for demographic variables, tobacco use, alcohol consumption, and drug abuse, results indicated a moderating effect of depression on the relationship between injection drug use and receipt of HIV screening (aOR = 0.85 [95% CI = 0.84, 0.86). Discussion Findings suggest that high risk subgroups such as injection drug users with severe depression may not be using HIV prevention services, leading to possible delays in HIV diagnosis. Integration of behavioral interventions and HIV prevention services may reduce risk factors among depressed injection drug users. Such interventions may improve retention for injection drug users who experience worse depressive symptoms post HIV diagnosis.

Funder

Substance Abuse and Mental Health Services Administration

Publisher

SAGE Publications

Subject

Health Policy,Leadership and Management

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Family support and treatment completion for unhealthy alcohol use in a SBIRT program;Journal of Social Work Practice in the Addictions;2024-05-09

2. A Geospatial Analysis of Social and Structural Determinants of Health and High HIV Prevalence in Alabama, USA;Journal of Community Health;2023-11-30

3. Informed policy making and research evidence;International Journal of Care Coordination;2021-03

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