DEPRESSION, DUAL DIAGNOSIS AND ANTIRETROVIRAL ADHERENCE

该项目的长期目标是研究HIV感染者抑郁、双重诊断和服药依从性之间的关系。了解脆弱人群中的依从性行为对于在所有HIV血清阳性人群中最大限度地发挥高效抗逆转录病毒疗法(HAART)的临床有效性至关重要。这项研究的具体目的是(1)描述目前接受HAART治疗的200名HIV感染者中抑郁和双重诊断(抑郁和药物滥用)的患病率，(2)描述抑郁、双重诊断和抗逆转录病毒依从性之间的关系，(3)检查抑郁、双重诊断和对家庭护理干预的反应之间的关系，以提高对HAART的依从性。这是一项前瞻性的描述性研究，嵌套在一项以家庭为基础的护理干预的随机临床试验中，以提高对HAART的依从性(Williams，A.)。受试者将是200名艾滋病病毒感染者，这些人都登记在父母研究中。抑郁的测量(自我报告、贝克抑郁问卷、MOS简表的5个条目的精神健康子量表)和药物滥用(自我报告)将被添加到父母研究数据收集工具中，并在面对面访谈中在基线上进行测量。依从性数据(通过自我报告、未公布的药片数量和MEMS上限数据衡量)将在基线时收集，每月收集3个月，然后每3个月收集一次，为期18个月。

The long-term objective of this project is to examine the relationship between depression, dual diagnosis and medication adherence in HIV infected individuals. Understanding adherence behaviors in vulnerable populations is essential to maximizing the clinical effectiveness of highly active antiretroviral therapy (HAART) among all HIV seropositive populations. The specific aims of this study are (1) to describe the prevalence of depression and dual diagnosis (depression and substance abuse) in a cohort of 200 HIV infected individuals currently treated with HAART, (2) to describe the relationship between depression, dual diagnosis and antiretroviral adherence, (3) to examine the relationship between depression, dual diagnosis and response to a home-based nursing intervention to improve adherence to HAART. This is a prospective, descriptive study nested in a randomized clinical trial of a home-based nursing intervention to improve adherence to HAART (Williams, A.). Subjects will be 200 HIV infected individuals enrolled in the parent study. Measures of depression (self-report, Beck Depression Inventory, 5-item mental health subscale of the MOS Short Form) and substance abuse (self-report) will be added to the parent study data collection instrument and measured at baseline in face to face interviews. Adherence data (measured by self report, unannounced pill counts and MEMS cap data) will be collected at baseline, monthly for 3 months then every 3 months for 18 months.