BACKGROUND The objective of this study was to examine depressive symptoms overtime and quantify the variance in symptoms attributable to substance use among a cohort of HIV-positive and HIV-negative men. METHODS Participants were enrolled in an NIH/NIDA funded cohort, with 534 men resulting in 1,888 visits between August 2014 and June 2018. Participants were between 18 and 45 years, and half were HIV-positive. At baseline and semi-annual visits, information was collected on depressive symptoms, sexual behaviors, and substance use. Changes overtime in symptom scores were evaluated using individual growth curve modeling. RESULTS The average CES-D20 score was 19.5 (SD = 12.7). Depressive symptoms were highest among daily/weekly methamphetamine users (56% vs. 39% occasional users and 27% non-users; p value<.01). Factors independently associated with depressive symptoms included methamphetamine use (adjusted OR = 1.5; 95% CI 1.1-2.3) and transactional sex (adjusted OR = 1.8; 95% CI 1.4-2.5). Based on growth curve modeling, methamphetamine was the most influential predictor of depressive symptoms, accounting for 10% of individual variance (p value<.01). Declines in depressive symptoms were noted for heavy users of a number of drugs, except for methamphetamine. For instance, those reporting daily/weekly heroin had a 3.38 point decline in CESD20 scores overtime (p value = 0.01). However, heavy methamphetamine users had much higher CESD20 scores and their scores remained high overtime (p value for change = 0.91). CONCLUSIONS The prevalence of depressive symptoms among this cohort of HIV-negative and HIV-positive MSM was high, especially among frequent methamphetamine users. These findings suggest that reducing methamphetamine use may have the potential to reduce depressive symptoms.

中文翻译：

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抑郁症状和物质使用：HIV 阳性和 HIV 阴性 MSM 人群中随时间的变化。

背景 本研究的目的是检查一段时间内的抑郁症状，并量化一组 HIV 阳性和 HIV 阴性男性中因药物使用而导致的症状差异。方法 参与者被纳入 NIH/NIDA 资助的队列，其中包括 534 名男性，2014 年 8 月至 2018 年 6 月期间进行了 1,888 次就诊。参与者年龄在 18 岁至 45 岁之间，其中一半是 HIV 阳性。在基线和半年访视时，收集有关抑郁症状、性行为和药物使用的信息。使用个体生长曲线模型评估症状评分随时间的变化。结果 CES-D20 平均得分为 19.5 (SD = 12.7)。每日/每周甲基苯丙胺使用者的抑郁症状最高（56% vs. 39% 偶尔使用者和 27% 不使用者；p 值 <.01）。与抑郁症状独立相关的因素包括甲基苯丙胺的使用（调整后的 OR = 1.5；95% CI 1.1-2.3）和性交易（调整后的 OR = 1.8；95% CI 1.4-2.5）。根据生长曲线模型，甲基苯丙胺是抑郁症状最有影响力的预测因子，占个体方差的 10%（p 值 <.01）。除甲基苯丙胺外，大量使用多种药物的抑郁症状有所下降。例如，那些每天/每周报告海洛因的人的 CESD20 分数随着时间的推移下降了 3.38 分（p 值 = 0.01）。然而，重度甲基苯丙胺使用者的 CESD20 分数要高得多，并且随着时间的推移，他们的分数仍然很高（变化 p 值 = 0.91）。结论 在 HIV 阴性和 HIV 阳性 MSM 人群中，抑郁症状的患病率较高，尤其是经常吸食甲基苯丙胺的人群。这些发现表明，减少甲基苯丙胺的使用可能有可能减轻抑郁症状。