Depression in the context of human immunodeficiency virus infection: implications for treatment

A chart review of 90 male outpatients was conducted to document the type of depressive symptomatology associated with HIV infection and to review the nature of antidepressant treatment provided in two university-affiliated outpatient settings. Forty-five individuals who tested positive for HIV infection and who were treated with antidepressant medications were compared with a like number of individuals who had no known risk factors as determined by chart review for HIV infection. Although depressive symptoms were generally similar among the two groups, HIV-positive individuals reported greater decreases in sleep and appetite than the HIV-negative comparison group. Overall, imipramine and fluoxetine earned the most favorable efficacy ratings while producing minimal side effect ratings in both HIV-positive and HIV-negative patients. Among the HIV-positive patients, the asymptomatic group had a better response to treatment with antidepressant medications than either the ARC or AIDS patient groups.