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. 2021 Jul;25(7):2230-2239.
doi: 10.1007/s10461-020-03151-2. Epub 2021 Jan 15.

HIV Infection and Depression Among Opiate Users in a US Epicenter of the Opioid Epidemic

Cecile M Denis  1   2 , Tiffany Dominique  3 , Peter Smith  3 , Danielle Fiore  3 , Yi-Chien Ku  3 , Angus Culhane  3 , Debora Dunbar  3 , Dana Brown  3 , Menvekeh Daramay  3 , Chelsea Voytek  3 , Knashawn H Morales  4 , Michael B Blank  3 , Paul F Crits-Christoph  3 , Steven D Douglas  5 , Serguei Spitsin  5 , Ian Frank  6 , Krystal Colon-Rivera  7 , Luis J Montaner  7 , David S Metzger  3 , Dwight L Evans  3
Affiliations

HIV Infection and Depression Among Opiate Users in a US Epicenter of the Opioid Epidemic

Cecile M Denis et al. AIDS Behav. 2021 Jul.

Abstract
in English, Spanish

Using a mobile research facility, we enrolled 141 opioid users from a neighborhood of Philadelphia, an urban epicenter of the opioid epidemic. Nearly all (95.6%) met DSM-5 criteria for severe opioid use disorder. The prevalence of HIV infection (8.5%) was more than seven times that found in the general population of the city. Eight of the HIV-positive participants (67.0%) reported receiving antiretroviral treatment but almost all of them had unsuppressed virus (87.5%). The majority of participants (57.4%) reported symptoms consistent with major depressive disorder. Severe economic distress (60.3%) and homelessness were common (57%). Polysubstance use was nearly universal, 72.1% had experienced multiple overdoses and prior medication for opioid use disorder (MOUD) treatment episodes (79.9%), but few currently engaged in addiction care. The prevalence, multiplicity and severity of chronic health and socioeconomic problems highlight consequences of the current opioid epidemic and underscore the urgent need to develop integrated models of treatment.

Utilizando un Centro de Investigación Móvil, inscribimos a 141 usuarios de opioides del vecindario de Filadelfia, un epicentro urbano de la epidemia de opioides. Casi todos (95,6%) cumplieron con los criterios del DSM-5 para el trastorno del uso severo del consumo de opioides. La prevalencia de la infección de VIH (8,5%) fue másﹶ de 7 veces superior a las encontrada en la población general de la ciudad. Ocho de los participantes con VIH positivo (67,0%) reportaron haber recibido tratamiento antirretroviral pero casi todos tuvieron virus no suprimido (87,5%). La mayoría de los participantes (57,4%) informaron síntomas compatibles con el Desorden Depresivo Mayor. La angustia severa por lo económico (60,3%) y las personas sin hogar fueron comunes (57%). El uso de múltiples sustancias fue casi universal, el 721% había experimentado múltiples sobredosis y previos medicamentos para el tratamiento del trastorno por consumo de opioides (MOUD) (79,9%), pero muy pocos estaban comprometidos con la atención a las adicciones. La prevalencia, la multiplicidad y la seriedad de los problemas de salud crónica y los problemas socioeconómicos destacan las consecuencias de la actual epidemia de opioides y subrayan la urgente necesidad de desarrollar nuevos modelos de tratamiento integrados.

Keywords: Depression; HIV; MOUD; Opioid; Risk behavior.

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