(P200) THE RELATIONSHIP BETWEEN NEW AWARENESS OF A SEXUALLY TRANSMITTED INFECTION AND DEPRESSIVE SYMPTOMS AMONG WOMEN WITH HIV IN THE UNITED STATES

Background:
Women with HIV (WWH) experience depressive symptoms at four times the rate of women without HIV. Co-infection with a sexually transmitted infection (STI) is common among WWH and may worsen depressive symptoms. We examined the relationship between a new awareness of an STI and depressive symptoms among WWH in the United States (US).

Methods:
The Women’s Interagency HIV Study (WIHS) is the longest standing cohort of WWH and women at risk for HIV in the US. The WIHS conducts psychosocial surveys and gynecological exams twice per year. This analysis used data from 2013-2019 on STIs (measured by self-report or study clinicians’ clinical impressions: chlamydia, gonorrhea, syphilis, herpes simplex 2, genital warts, or trichomoniasis) and depressive symptoms [measured via CES-D 20 scores (range 0 – 60)]. Generalized linear models with generalized estimating equations estimated the longitudinal, unadjusted association between new awareness of an STI (yes/no) and depressive symptoms.

Results:
Overall, 1,770 WWH contributed 17,258 visits to the analysis. At first visit, median age was 38 (IQR: 31,45) and 33% were never married; 72% of participants were non-Hispanic Black. Thirty percent of WWH had a new STI during the 6-year follow-up, including 15% who had a new STI at ≥2 visits. At visits with a new STI, WWH had higher mean depressive symptoms than at visits without a new STI (12.58 vs. 12.12) a mean increase of 0.47 (95% CI: -0.07, 1.00) in CES-D score.

Conclusion:
At visits with a new STI, WWH had increased depressive symptoms compared to visits without a new STI. It is possible that a new STI may remind women of their HIV diagnosis and lead to retraumatization (a process that reshapes a reaction to a trauma based on previous trauma). Providing increased mental health support at the time of a new STI may reduce depressive symptom burden.