Severe adverse life events and depressive symptoms among women with, or atrisk for, HIV infection in four cities in the United States of America

Objective: To examine frequency and predictors of severe adverse life event s and depressive symptoms among HIV-infected women and a comparison group o f uninfected women. Design: Analysis of baseline data collected from HIV-infected and uninfecte d women in a prospective cohort study of HIV infection and women, the HIV E pidemiologic Research Study. Method: The sample of 871 HIV-infected and 439 demographically and behavior ally similar uninfected women were recruited from four metropolitan areas i n the USA. Women provided interview information that included sociodemograp hic characteristics, sexual and drug-using behaviors, and social and psycho logical functioning. The outcome measures were number of severe adverse lif e events (e.g., insufficient money for necessities, physical attack or rape , death of a person close to them) and levels of depressive symptoms. Results: HIV-infected and uninfected women reported numerous adverse life e vents and high levels of depressive symptoms. The two groups, however, did not differ on either outcome measure. Low socio-economic status, injecting drug and crack cocaine use, and high risk sexual activity were related to r eports of more adverse events and depressive symptoms for both groups, Conclusions: HIV-infected and uninfected women in socially and economically disadvantaged environments experience many adverse events and high levels of depressive symptoms. HIV infection, at least during the early phase, may be less important than socio-environmental factors in predicting negative psychosocial outcomes for women. (C) 1999 Lippincott Williams & Wilkins.