ABSTRACT
We conducted a parallel-group randomized controlled trial in three HIV clinics in Mexico to evaluate a user-centred habit-formation intervention to improve ART adherence among MSM living with HIV. We randomized 74 participants to the intervention group and 77 to the control group. We measured adherence at one, four, and ten months through medication possession ratio and self-reported adherence. Additionally, we measured viral load, CD4 cell count, major depression disorder symptoms, and alcohol and substance use disorder at baseline, fourth and tenth months. We found no statistically significant effect on adherence between groups. However, the intervention demonstrated positive results in major depression disorder symptoms (21% vs. 6%, p = 0.008) and substance use disorder (11% vs. 1%, p = 0.018) in the fourth month. The latter is relevant because, in addition to its direct benefit, it might also improve the chances of maintaining adequate adherence in the long term. This trial was retrospectively registered at ClinicalTrials.gov (trial number NCT03410680) on 8 January 2018.Trial registration: ClinicalTrials.gov identifier: NCT03410680.
Subject(s)
Anti-HIV Agents , HIV Infections , Homosexuality, Male , Medication Adherence , Viral Load , Humans , Male , Mexico , HIV Infections/drug therapy , HIV Infections/psychology , Adult , Homosexuality, Male/psychology , Medication Adherence/statistics & numerical data , Medication Adherence/psychology , Anti-HIV Agents/therapeutic use , Middle Aged , Substance-Related Disorders , CD4 Lymphocyte Count , Depressive Disorder, Major/drug therapyABSTRACT
OBJECTIVE: To assess changes in the prevalence of de-pressive symptoms (DS) and in detection and treatment coverage between 2006 and 2018, and to identify the socio-demographic factors associated with the latter. MATERIALS AND METHODS: We used data from the Ensanut 2006, 2012, 2018-19, 100k. We used logistic regression to explore demographic factors associated with coverage of detection and treatment of depression. RESULTS: The prevalence of DS was respectively: 15.4, 13.7, 13.6 and 15.0%. Living in munici-palities with a very high and high degree of marginalization was associated with less coverage of detection and treatment of depression. CONCLUSIONS: This work provides evidence on the gaps that exist in access to mental health services between regions and different levels of marginalization and highlights the need to direct efforts to increase access to health services that allow timely diagnosis and treatment of DS and depression.
OBJETIVO: Estimar cambios en la prevalencia de síntomas depresivos (SD) y en la cobertura de detección y tratamiento entre 2006 y 2018, e identificar los factores sociodemográfi-cos asociados con estos últimos. MATERIAL Y MÉTODOS: Se utilizaron datos de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2006, 2012, 2018-19 y 100k. Usamos regresión logística para explorar factores demográficos asociados con detección y tratamiento de depresión. RESULTADOS: La prevalencia de SD fue respectivamente de 15.4, 13.7, 13.6 y 15.0%. Vivir en municipios con muy alto y alto grado de marginación se asoció con menor cobertura de detección y tratamiento de depresión. CONCLUSIONES: Este trabajo brinda evidencia sobre las brechas que existen en el acceso a servicios de salud mental entre regiones y diferentes niveles de marginación, y resalta la necesidad de encaminar esfuerzos para incrementar acceso de servicios de salud que permitan el diagnóstico y tratamiento oportunos de SD y la depresión.
Subject(s)
Depression , Mental Health Services , Depression/diagnosis , Depression/epidemiology , Depression/therapy , Humans , Mexico/epidemiology , PrevalenceABSTRACT
Abstract Objective: To assess changes in the prevalence of depressive symptoms (DS) and in detection and treatment coverage between 2006 and 2018, and to identify the sociodemographic factors associated with the latter. Materials and methods: We used data from the Ensanut 2006, 2012, 2018-19, 100k. We used logistic regression to explore demographic factors associated with coverage of detection and treatment of depression. Results: The prevalence of DS was respectively: 15.4, 13.7, 13.6 and 15.0%. Living in municipalities with a very high and high degree of marginalization was associated with less coverage of detection and treatment of depression. Conclusions: This work provides evidence on the gaps that exist in access to mental health services between regions and different levels of marginalization and highlights the need to direct efforts to increase access to health services that allow timely diagnosis and treatment of DS and depression.
Resumen Objetivo: Estimar cambios en la prevalencia de síntomas depresivos (SD) y en la cobertura de detección y tratamiento entre 2006 y 2018, e identificar los factores sociodemográficos asociados con estos últimos. Material y métodos: Se utilizaron datos de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2006, 2012, 2018-19 y 100k. Usamos regresión logística para explorar factores demográficos asociados con detección y tratamiento de depresión. Resultados: La prevalencia de SD fue respectivamente de 15.4, 13.7, 13.6 y 15.0%. Vivir en municipios con muy alto y alto grado de marginación se asoció con menor cobertura de detección y tratamiento de depresión. Conclusiones: Este trabajo brinda evidencia sobre las brechas que existen en el acceso a servicios de salud mental entre regiones y diferentes niveles de marginación, y resalta la necesidad de encaminar esfuerzos para incrementar acceso de servicios de salud que permitan el diagnóstico y tratamiento oportunos de SD y la depresión.
