242941 Do women's levels of depression moderate sexual risk behavior change in HIV prevention interventions? A meta-analysis

Wednesday, November 2, 2011

Carter A. Lennon, MA , Department of Psychology, University of Connecticut, Storrs, CT
Tania B. Huedo-Medina , Center for Health Intervention and Prevention, University of Connecticut, Storrs, CT
Daniel P. Gerwien, BA , Advanced Behavioral Health, Middletown, CT
Blair T. Johnson, PhD , Department of Psychology, University of Connecticut, Storrs, CT
Background: Rates of HIV/AIDS are rising in ethnic/racial minority women in the United States (CDC, 2008) and women are disproportionately affected by depression (CDC, 2009). HIV/AIDS and depression share a number of common risk factors, including drug and alcohol use and low socioeconomic status (Beadnell et al., 2003). The objective of this meta-analysis was to examine how depression affects sexual risk behavior outcomes in women participating in HIV/AIDS prevention interventions. Methods: HIV/AIDS primary prevention interventions that measured a sexual risk behavior and depression at baseline and follow-up(s) and reported separate results for women were included. Fourteen interventions (N = 5,250 women) met the inclusion criteria. Participants were, on average, 28 years old and African American. Effects sizes were calculated using the standardized mean difference (d). Results: A significant decrease in depression in both groups from baseline to short-term (d+ = -0.29) and long-term (d+ = -0.20) follow-ups was found as well as a significant decrease in sexual risk behavior from baseline to short-term (d+ = -0.32) and long-term (d+ = -0.20) follow-ups. Overall, baseline levels of depression acted as a moderator of sexual risk behavior, with higher levels of initial depression leading to greater decrease in sexual risk behavior at short-term and long-term follow-ups. Conclusions: Depression appears to play a role in decreasing sexual risk behavior, highlighting the need to consider addressing depression in intervention design content. Researchers who design interventions can look to meta-analysis findings as another tool for aiding in creating effective HIV prevention interventions.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Social and behavioral sciences

Learning Objectives:
1. Explain how depression and sexual risk behavior reduction are related. 2. Discuss why depression is not addressed in the context of HIV prevention interventions and the utility of addressing mental health needs. 3. Design primary HIV prevention interventions for women that address mental health and sexual risk reduction needs.

Keywords: Women and HIV/AIDS, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted a meta-analysis that is relevant to the primary prevention of HIV in women.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.