Introduction: Although depression is common among HIV-positive injection drug users (IDUs), little is known about differences between male and female HIV-positive IDUs.

Methods: We used baseline data for 1126 HIV-positive IDUs from a behavioral intervention trial from 2001 through 2005 in 4 US cities. Using the Brief Symptom Inventory-18, scores indicating high risk for depression were calculated separately for men and women based on raw scores of 9 for women and 7 for men. We did separate logistic regressions for men and women to evaluate correlates of depression in 4 domains: sociodemographic, psychosocial, substance use, and sexual behaviors/attitudes.

Results: Approximately one third of women and men met the criteria for being at high risk of depression. Women reported significantly more depressive symptoms than men. Correlates linked with depression for both genders included perceived functional limitation, greater negative feelings regarding condom use, lower social support, and lower sense of empowerment. Being physically abused as adults and being Hispanic were correlates specific to men. No unique correlate was identified for women.

Discussion: Because of the high prevalence of depression among HIV-positive IDUs, caregivers should screen HIV-positive IDUs for depression and consider treatment for depression. Because of the similarities in correlates of depression among men and women, case finding and interventions for depression are likely to be similar for male and female HIV-positive IDUs.

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