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Judith A. Cook, PhD, Dennis Grey, BA, Jane Burke, MS, Mardge H. Cohen, MD, Alejandra C. Gurtman, MD, Jean L. Richardson, DrPH, Tracey E. Wilson, PhD, Mary A. Young, MD and Nancy A. Hessol, MSPH

Judith A. Cook, Dennis Grey, and Jane Burke are with the Department of Psychiatry, University of Illinois at Chicago. Mardge H. Cohen is with the Cook County Hospital, Core Center, Chicago Ill. Alejandra C. Gurtman is with the Department of Medicine, Mount Sinai Medical Center, New York, NY. Jean L. Richardson is with the Department of Preventive Medicine, University of Southern California, Los Angeles. Tracey E. Wilson is with the Department of Preventive Medicine and Community Health, State University of New York Health Sciences Center at Brooklyn. Mary A. Young is with the Department of Medicine, Georgetown University Medical Center, Washington, DC. Nancy A. Hessol is with the Department of Medicine, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Judith A. Cook, PhD, Mental Health Services Research Program, Department of Psychiatry, University of Illinois at Chicago, 104 S Michigan Ave, Suite 900, Chicago, IL 60603 (e-mail: cook{at}ripco.com).

Objectives. We examined associations between depressive symptoms and AIDS-related mortality after controlling for antiretroviral therapy use, mental health treatment, medication adherence, substance abuse, clinical indicators, and demographic factors.

Methods. One thousand seven hundred sixteen HIV-seropositive women completed semiannual visits from 1994 through 2001 to clinics at 6 sites. Multivariate Cox and logistic regression analyses estimated time to AIDS-related death and depressive symptom severity.

Results. After we controlled for all other factors, AIDS-related deaths were more likely among women with chronic depressive symptoms, and symptoms were more severe among women in the terminal phase of their illness. Mental health service use was associated with reduced mortality.

Conclusions. Treatment for depression is a critically important component of comprehensive care for HIV-seropositive women, especially those with end-stage disease.

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