Brief communication: Detecting depression: Providing high quality primary care for HIV-infected patients

Depression is common among HIV-infected patients, but little is known about risk factors for depression in this population. Several studies before pro tease inhibitors became available have reported inconsistent associations b etween depression and disease severity, Delivering high quality HIV care in cludes adequate detection and treatment of depression. The objective of thi s study was to describe the prevalence and correlates of depression among a contemporary group of HIV-infected patients. The setting and design for th e study was a chart abstraction for HIV-infected patients in a primary care practice in Boston, Mass, in June 1997, Among 275 HIV-infected patients, d epression was documented in 147 patient charts (53%), half of whom (n. = 73 , 27%) also received antidepressant medications. We used multivariable logi stic regression to identify risk factors for depression among patients with both a chart diagnosis of depression and current antidepressant medication use. We observed increased risk of depression among patients with a histor y of substance use (odds ratio 2,7, 95% confidence interval 1.5-4.7), recen t medical hospitalization (2,6, 1,4-5,0), and homosexual risk behavior (2,1 , 1,1-4.2), Depression remains a common problem for HIV-infected patients, particularly among those with history of substance abuse, medical hospitali zation, or homosexual risk behavior. Routine screening for depression in th is population with special attention to those at higher risk may offer oppo rtunities for earlier diagnosis and treatment.