HIV INFECTION AND INJECTION DRUG USE: The Importance of Gender

HIV INFECTION AND INJECTION DRUG USE:The Importance of Gender 1Amy B. Wisniewski, Ph.D. 2Adrian S. Dobs, M.D., MPH Departments of Pediatrics1 and Medicine2

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 forsex differences

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

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

PARTICIPANTS

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 1R01DA/DKR814-6141

HIV INFECTION AND INJECTION DRUG USE: The Importance of Gender