PSYCHOPATHOLOGY IN MALE AND FEMALE HIV-POSITIVE AND NEGATIVE INJECTING DRUG-USERS - LONGITUDINAL COURSE OVER 3 YEARS

Objective: To evaluate the impact of HIV illness on psychiatric and ps ychosocial functioning over 3 years in a sample of male and female HIV -positive injecting drug users (IDU), with a comparison group of HIV-n egative male and female IDU. Design: As part of a multidisciplinary st udy, 121 men (69 HIV-positive, 52 HIV-negative) and 66 women (36 HIV-p ositive, 30 HIV-negative) were evaluated semiannually for seven visits . Attrition, unrelated to sex or serostatus, was 33%.Results: At basel ine, rates of major depression and dysthymia ranged from 15% (HIV-nega tive men) to 33% (HIV-positive men and HIV-negative women). Global imp airment was in the range found in psychiatric patients (mean Global As sessment of Functioning scores, 46-51). Higher levels of social suppor t and less social conflict were independently associated with decrease d distress and improved global functioning among both men and women. F or both HIV-positive groups, degree of improvement over time was relat ed to degree of HIV progression: those who remained healthier in terms of CD4 count and illness stage showed more improvement. HIV-seronegat ive status was associated with less distress for men but not for women . Overall, women reported higher levels of psychiatric distress than m en. Conclusions: High rates of psychopathology were found in this IDU cohort, independent of HIV status and sex. Although rates of psychopat hology, injecting drug use and distress declined slightly during the s tudy, they remained elevated; accordingly, psychiatric services are in dicated for this population.