Depression: HIV's Ally

Just surviving is often a daily struggle for people living deep in America's inner cities. The pervasive poverty, violence and drug use add up to alarmingly high rates of depression and psychological distress among inner-city African Americans.

Recent research by Carl Latkin, PhD, professor of Health, Behavior and Society (HBS), also finds that depression can foster HIV sexual risk behaviors in impoverished urban populations, including having multiple sex partners or unprotected sex, and the exchange of sex for drugs. The studies by Latkin and others show that over half of the sample populations screened for depression scored high on the survey.

The findings suggest that treating depression could help reduce the high rates of new HIV infections in distressed neighborhoods.

To that end, Latkin is overseeing the development of a pilot program in Baltimore to treat depression among drug users through cognitive behavioral group therapy. The goal of the intervention is twofold: to reduce the depressive symptoms, as well as the likelihood that the participants will engage in high-risk sexual behaviors and drug use.

"Some people may engage in the behaviors as a way of self-medicating, a way of getting pleasure when they're distressed," says Latkin. "Or they may engage in risk behaviors out of a sense of hopelessness and not really seeing that they have a future."

He says that group therapy sessions might teach clients to be aware of common negative ruminations—"Nothing is going well in my life so why use a condom?"—and replace them with healthier thoughts—"I'm really proud that I haven't used drugs in X number of days." The sessions will also focus on healthy means of coping such as exercise and socializing with supportive friends.

The program will be based at The Lighthouse, an East Baltimore community-centered HBS research facility that works to improve the health of disadvantaged urban populations.

To tailor the therapy sessions to the clients' lives and their neighborhood experiences, Latkin and his colleagues are interviewing community residents to identify factors that contribute to the onset of depression.

"We're trying to adapt models to the community and their unique issues and concerns," Latkin says. "Ideally, we'd like to strengthen the community."