HIV INFECTION AND INJECTION DRUG USE The Importance

OBJECTIVES • To determine the impact of gender on depression, quality of life (QOL)

IMPORTANCE • By considering gender in the natural history of HIV and IDU, personalized

BACKGROUND • Most studies that describe mental health and cognition in HIV/AIDS and IDU

• The National Academy of Sciences recommends that health research include men and

• Depression, poor QOL and cognitive impairment are known consequences of HIV/AIDS •

STUDY DESIGN Men and Women matched by • • • Age Race Education SES

PARTICIPANTS Gender Male N (%) 31 (51) HIV status Female HIV+ 30 (49) 27

PARTICIPANTS Males Females HIV-IDU- 9 8 HIV+IDU- 9 6 HIV-IDU+ 5 10 HIV+IDU+ 8

RESULTS More women than men reported depression (CESD > 16)

Women who were both HIV+ and IDU+ were the most likely to report depression

Women were more likely to show poor (lower) QOL/physical health scores than men, when

HIV+ participants were more likely to show poor (lower) QOL/physical health scores than HIV-

HIV+ participants were more likely to show poor (lower) QOL/mental health scores than HIV-

COGNITIVE SCORES • In general, women outperform men on tests of verbal memory •

HIV STATUS AND GENDER INTERACT HIV- women perform best, and HIV+ men perform the

SUMMARY • Females are at greater risk of depression than males • This sex

• Women and HIV+ participants were most likely to report poor QOL scores

CONCLUSIONS • HIV and IDU are associated with depression and poor QOL in women,

SIGNIFICANCE • Medical treatments for HIV/AIDS and IDU should be tailored to meet the

ACKNOWLEDGEMENTS • • Vickie Sinkler Rosa Sebree Samantha Apel NIH 1 R 01 DA/DKR

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HIV INFECTION AND INJECTION DRUG USE: The Importance of Gender 1 Amy B. Wisniewski, Ph. D. 2 Adrian S. Dobs, M. D. , MPH Departments of Pediatrics 1 and Medicine 2

OBJECTIVES • To determine the impact of gender on depression, quality of life (QOL) and cognition in HIV infected, injection drug using populations

IMPORTANCE • By considering gender in the natural history of HIV and IDU, personalized treatments can be developed to optimize outcome

BACKGROUND • Most studies that describe mental health and cognition in HIV/AIDS and IDU have focused solely on men

• The National Academy of Sciences recommends that health research include men and women • Researchers should analyze their data for sex differences

• Depression, poor QOL and cognitive impairment are known consequences of HIV/AIDS • Women, in general, report more depressive symptoms than men

STUDY DESIGN Men and Women matched by • • • Age Race Education SES IDU Outcome Measures • Depression – CESD • QOL – MOS-HIV • Cognition – Verbal memory – Perceptual speed

PARTICIPANTS Gender Male N (%) 31 (51) HIV status Female HIV+ 30 (49) 27 (44) IDU status HIVIDU+ 34 (56) 31 (50) Education IDU> 12 th grade 30 (49) 40 (66) < 12 th grade 21 (34)

PARTICIPANTS Males Females HIV-IDU- 9 8 HIV+IDU- 9 6 HIV-IDU+ 5 10 HIV+IDU+ 8 6

RESULTS More women than men reported depression (CESD > 16)

Women who were both HIV+ and IDU+ were the most likely to report depression (CESD > 16)

Women were more likely to show poor (lower) QOL/physical health scores than men, when adjusted for HIV and IDU.

HIV+ participants were more likely to show poor (lower) QOL/physical health scores than HIV- participants.

HIV+ participants were more likely to show poor (lower) QOL/mental health scores than HIV- participants.

COGNITIVE SCORES • In general, women outperform men on tests of verbal memory • In general, HIV- outperform HIV+ participants on measures of perceptual speed

HIV STATUS AND GENDER INTERACT HIV- women perform best, and HIV+ men perform the worst on a test of delayed verbal memory (p <. 05).

SUMMARY • Females are at greater risk of depression than males • This sex difference in depression is most pronounced in females who are both HIV+ and IDU+

• Women and HIV+ participants were most likely to report poor QOL scores • HIV+ men were most likely to exhibit poor verbal memory

CONCLUSIONS • HIV and IDU are associated with depression and poor QOL in women, but not men • HIV is associated with poor verbal memory in men, but not women

SIGNIFICANCE • Medical treatments for HIV/AIDS and IDU should be tailored to meet the specific needs of affected men and women

ACKNOWLEDGEMENTS • • Vickie Sinkler Rosa Sebree Samantha Apel NIH 1 R 01 DA/DKR 814 -6141