Antidepressant Medication for Reducing HIV Risk Behavior in Depressed Intravenous Drug Users

Study Overview
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Brief Summary
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This study will evaluate the effectiveness of antidepressant medication treatment in reducing HIV risk behaviors in intravenous drug users with depression.

Detailed Description
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Depression and injection drug use often come hand-in-hand. This is especially true in populations with limited access to mental health care and with a high risk of illness and HIV transmission. Depressed injection drug users in these populations usually continue their drug use for extended periods of time, thereby further promoting the spread of HIV. This cycle has created a significant public health problem. It is necessary to explore new approaches to facilitate and maintain long-term behavior changes within this population. This study will evaluate the effectiveness of treatment with antidepressant medications in reducing HIV risk behaviors in depressed intravenous drug users. Participants in this open label study will be randomly assigned to receive either antidepressant treatment or no treatment. Participants in the treatment group will meet with a psychiatrist monthly for 12 months. Based on psychiatric evaluations and participants' medical histories, doctors will prescribe an appropriate antidepressant medication or a combination of medications. Participants in the treatment group may also receive referrals for other services if necessary. Participants assigned to receive no treatment will be contacted at Months 3 and 9 to verify their contact information; they will also receive any necessary referrals. All participants will partake in interviews at baseline and Months 6 and 12 to assess changes in HIV risk behavior and depressive symptoms.

Official Title
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Maintaining HIV Risk Reduction Among Needle Exchangers

Conditions
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Depression, Substance-Related Disorders, HIV Infections

Intervention / Treatment
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* Drug: Antidepressant Medication


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: DSM-IV diagnosis of major depression, dysthymia, substance-induced major depression, or major depression plus dysthymia Score of greater than 14 on the Hamilton Rating Scale for Depression Current opiate or cocaine use History of injection equipment sharing English-speaking Exclusion Criteria: History of injection equipment sharing within 6 months of study entry Currently at risk for suicide Currently experiencing symptoms of psychosis Currently taking any other psychotropic medication Diagnosed with bipolar disorder, schizophrenia, schizoaffective disorder, schizophreniform disorder, or paranoid disorder Informed that treatment with antidepressant medications is medically inadvisable Pregnant

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Antidepressant Medication|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maintenance of HIV risk-free drug behavior (measured at Month 12) |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduction in depressive symptoms (measured at Month 12) |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Injection Drug Use, HIV Risk Behavior, HIV Seronegativity