Depression, drug use, and HIV among the heterosexual group in impoverished urban areas of Washington DC

Objective: This study assessed the risks and prevalence for depressive symptoms among heterosexuals residing in areas of high HIV prevalence and high poverty in Washington, DC.

Methods: The first heterosexual cycle (HET-1) of the National HIV Behavioral Surveillance System in Washington, DC conducted in 2007 provided information on demographics, sexual/drug use behaviors, and HIV status. Participants were recruited using respondent driven sampling. Center for Epidemiologic Studies-Depression scale scores were used to assess depressive symptom with a cutpoint at ≥16.

Results: Of 735 participants, 58.9% were male, 4.7% HIV positive, 27.5% used non-injection drugs before/during last sex, 76.5% reported having income at <$0,000 annually, 20.0% had ever been homeless, 38.0% reported ever being physically or emotionally abused. Of the participants, 43.6% reported experiencing depressive symptoms in the past week, nearly two-thirds (63%) reported using non-injection drugs in the past year. In the multivariable logistic regression model, participants experiencing depressive symptoms in the past week were more likely to have lower income (AOR=1.7; 95%CI: 1.1-2.9, <$20,000 annually), had ever been homeless (OR=2.5; 95%CI: 1.3-3.8), had used non-injection drugs before/during last sex (AOR=1.6; 95%CI: 1.0-2.5), and had ever being physically or emotionally abused(AOR=1.8; 95%CI: 1.2-2.8).

Conclusion: Depressive symptoms were common among this sample of heterosexuals residing high HIV prevalence and high-poverty areas. The findings underscore the need for an innovative HIV prevention strategy integrating mental health and harm reduction components. Further research is needed to better understand how depressive illness might affect HIV transmission among this group.