Combination Antiretroviral Therapy and Improvements in Mental Health

Results from a Nationally Representative Sample of Persons Undergoing Care for HIV in the United States

Kitty S. Chan, Maria Orlando Edelen, Geoffrey F. Joyce, Allen Gifford, M. Audrey Burnam, Joan S. Tucker, Cathy Donald Sherbourne

ResearchPosted on rand.org 2003Published in: JAIDS, Journal of Acquired Immune Deficiency Syndromes, v. 33, no. 1, May 1, 2003, p. 104-111

OBJECTIVE: To test whether mental health improvements observed in a nationally representative sample of 2466 HIV+ persons receiving care in the United States during the dissemination of combination antiretroviral therapy (ART) is a result of global optimism or directly related to treatment. ANALYSIS: Data were analyzed by means of a linear regression model of the change in psychiatric symptoms from baseline (January 1996-April 1997) to the first followup interview approximately 8 months later as a function of changes in CD4+ counts, opportunistic infection treatments, and HIV physical symptoms in the overall sample and separately in participants who maintained ART, initiated ART, never received ART, or transitioned to a less recommended regimen during the study period. RESULTS: The reduction in psychiatric symptoms was comparable across all treatment groups (p > .05), suggesting a global effect. In patients who initiated or maintained ART, fewer psychiatric symptoms were significantly related to higher CD4+ and fewer opportunistic infection treatments and HIV symptoms, however, suggesting a treatment effect. CONCLUSION: ART appears to be responsible for both a treatment-specific and global improvement in the mental health of HIV+ patients, possibly through the promise of extended survival and a better quality of life.

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Document Details

  • Availability: Non-RAND
  • Year: 2003
  • Pages: 8
  • Document Number: EP-200305-04

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