Determinants of benzodiazepine use in a representative population of HIV-infected individuals: the role of HIV status disclosure (ANRS-EN12-VESPA study)

Abstract

HIV infection may result in stressful situations such as disclosure to others and could be a mediator between seropositivity status and psychiatric illness, depression, or anxiety. Several results have shown that anxiolytic use (mainly benzodiazepines [BDZ]) is highly prevalent in HIV-infected individuals, but few studies have highlighted to what extent this use could be associated with HIV disclosure. A national cross-sectional survey representative of people living with HIV and AIDS in France enrolled 2932 individuals in 102 French HIV hospital departments. Face-to-face interviews and self-administered questions collected information about patients’ experience with HIV and HIV care, including use of psychotropic drugs, social support, stigma, and disclosure of HIV status. We identified factors associated with regular BDZ use (i.e., more than once a week) using a weighted logistic regression model. Regular BDZ use and anxiety symptoms were reported by 16% and 29% of the patients, respectively. After multiple adjustment for known correlates of BDZ use and anxiety symptoms, individuals who had disclosed their HIV status to relatives or friends were found to be more likely (OR [95% CI] = 1.78 [1.02–3.09]) to regularly use BDZ. These results show both to what extent disclosure to others continues to be a stressful step in the course of HIV infection and that disclosure is something that could be identified by BDZ use. They also highlight the need for appropriate case management and psychiatric care to help patients manage the consequences of disclosure.

Keywords:

• disclosure
• benzodiazepine
• anxiety
• HIV
• stigma

Acknowledgements

This study was supported by the French National Agency of AIDS and Hepatitis Research (ANRS, France). Special thanks to the members of the VESPA Group: C. Afsa (INSEE), A. Bonnet (UFR Psychopathologie, Université de Provence), A.D. Bouhnik (INSERM U912/ORS PACA), V. Di Paola (LEST), R. Dray-Spira (INSERM U88), J. Fagnani (CNRS-UMR Matisse), L. Fernandez (UFR Psychopathologie, Université de Provence), I. Heard (INSERM U430), F. Lert (INSERM U88), Y. Obadia (ORS PACA/INSERM U912), J.L. Pedinielli (UFR Psychopathologie, Université de Provence), P. Peretti-Watel (ORS PACA/INSERM U912), J. Pierret (CERMES-INSERM U504-UMR 8559), B. Riandey (INED), M.A. Schiltz (CERMES-INSERM U504-UMR 8559), R. Sitta (INSERM U88), and B. Spire (INSERM U912/ORSPACA).