Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 15;36(9):1295-1304.
doi: 10.1097/QAD.0000000000003268. Epub 2022 May 25.

Incident depression among Medicare beneficiaries with disabilities and HIV

Xiaoying Yu  1   2 , Jacques Baillargeon  1 , Abbey B Berenson  2   3 , Jordan R Westra  1 , Thomas P Giordano  4   5 , Yong-Fang Kuo  1   2
Affiliations

Incident depression among Medicare beneficiaries with disabilities and HIV

Xiaoying Yu et al. AIDS. .

Abstract

Objective: Despite disproportionally high prevalence of HIV and depression in persons with disabilities, no data have been published on the incidence and correlates of depression in Medicare beneficiaries with disabilities. We assessed the effect of HIV infection on developing depression in this population.

Design: We conducted a retrospective matched cohort study using a 5% sample of Medicare beneficiaries who qualified for disability coverage (1996-2015).

Methods: Beneficiaries with incident ( n = 2438) and prevalent ( n = 5758) HIV were individually matched with beneficiaries without HIV (HIV-, n = 20 778). Fine-Gray models with death as a competing risk were used to assess the effect of HIV status, age, and cohort period on developing depression by sex strata.

Results: Beneficiaries with HIV had a higher risk of developing depression within 5 years ( P < 0.0001). Sex differences were observed ( P < 0.0001), with higher subdistribution hazard ratios (sHR) in males with HIV compared with controls. The risk decreased with age ( P < 0.0001) and increased in recent years ( P < 0.0001). There were significant age-HIV ( P = 0.004) and period-HIV ( P = 0.006) interactions among male individuals, but not female individuals. The sHR was also higher within the first year of follow-up among male individuals, especially those with incident HIV.

Conclusion: Medicare enrollees with disabilities and HIV had an increased risk of developing depression compared to those without HIV, especially among males and within the first year of HIV diagnosis. The HIV-depression association varied by sex, age, and cohort period. Our findings may help guide screening and comprehensive management of depression among subgroups in this vulnerable population.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest:

There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Non-parametric Cumulative Incidence Functions by HIV Status for any Depression Event Within Five Years
Figure 2.
Figure 2.
Stratum Specific Subdistribution Hazard Ratios Over Follow-up Period by HIV Infection Status Among Males
See this image and copyright information in PMC

References

    1. Social Security Administration. Definition of Disability. https://www.ssa.gov/OP_Home/cfr20/404/404-1505.htm. Published 2012. Accessed April 10, 2022.
    1. Social Security Administration. Appendix 1 to Subpart P of Part 404—Listing of Impairments. https://www.ssa.gov/OP_Home/cfr20/404/404-app-p01.htm. Accessed April 10, 2022.
    1. Social Security Administration. Disability Benefits. https://www.ssa.gov/benefits/disability/approval.html. Accessed April 10, 2022.
    1. Centers of Medicare & Medicaid Services. Original Medicare (Part A and B) Eligibility and Enrollment. https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePart.... Accessed April 10, 2022.
    1. Mues KE, Liede A, Liu J, Wetmore JB, Zaha R, Bradbury BD, et al. Use of the Medicare database in epidemiologic and health services research: a valuable source of real-world evidence on the older and disabled populations in the US. Clin Epidemiol 2017; 9:267–277. - PMC - PubMed

Publication types