Minority Women With Dysthymia, A Form Of Depression, May Be Less Likely To Receive HAART

Results of a study involving almost 2,000 HIV-infected people receiving HIV care show that African-American and Hispanic women with dysthymia, a less intense but chronic form of depression, were half as likely to receive lifeprolonging highly active antiretroviral therapy (HAART) compared with white men with no accompanying mental disorder. Background: It is known that women are less likely than men to receive HAART, and that members of racial/ethnic minorities often lack access to HAART therapies. The impact of major depression on the receipt of antiretroviral therapy has also been well-described. However, there is a lack of research on the effects of dysthymia in HIV-infected people. The research sought to determine whether or not the feelings of hopelessness, indecision, and mental inflexibility that commonly occur with dysthymia could impact patients being offered or accepting HAART. Study Design: The researchers used the sample of 1,982 HIV-infected adults from the HIV Costs and Service Utilization Study, a nationally representative probability sample of HIV-infected adults receiving HIV care in the United States. They interviewed the participants and categorized them according to gender and race/ethnicity. The scientists assessed mental health disorders as well as demographic information over a 12-month period. Dysthymia was identified if a person felt sad or depressed much of the time during the 12 months; sad or depressed at least half of the day; and had at least two of these symptoms: hopelessness, loss of appetite, lack of energy, or inability to make decisions. What They Found: Overall, 63 percent of participants received HAART. White men were the most likely to receive it, while Hispanic women were least likely. Dysthymia was significantly more common in women than in men, occurring in nearly 33 percent of women versus less than 20 percent of men. Minority women with dysthymia had approximately 50 percent lower odds of receiving HAART than white men without this condition. A statistical analysis showed that rates of HAART use were lower among African-American and Hispanic women with dysthymia (49 percent and 45 percent, respectively) than among African-American and Hispanic women without dysthymia (58 percent and 59 percent, respectively). Comments From The Authors: Our data point to dysthymia as a potentially important contributing factor to deficient receipt of life-prolonging HIV medication by minority women. We believe this evidence should prompt clinicians to consider screening for dysthymia, especially in this group (minority, HIV-infected women). What's Next: These findings may prompt physicians to screen for this mental disorder, particularly among minority women with HIV. The data also reinforce the need for continued research into health disparities among minority women. Publication: Dr. Barbara Turner of the University of Pennsylvania and her colleagues published their study in the December 2006 issue of the Journal of General Internal Medicine. The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics are available in English and Spanish. These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at

(Author: www.drugabuse.gov)

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