HPG function in men and women stratified by drug use and HIV status
Wisniewski, Amy B.
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Most studies of hypothalamic-pituitary-gonadal (HPG) function and depression in illicit drug users focus only on men or do not consider the impact of HIV infection along with drug use. This study investigated relationships between illicit drug use and HIV status with depressive symptoms and HPG function in both men and women. Illicit drug use and HIV status were differentially associated with HPG function and depressive symptoms in men and women. Specifically, free testosterone concentrations were lower in men who use drugs and in women who are HIV positive. Estradiol concentrations were marginally lower in women, but not in men, who are HIV positive. Women and drug users reported the most depressive symptoms; however, impaired HPG function was associated with increased depressive symptoms in men only. Neither HPG function nor depression was impacted in an additive or synergistic manner by both drug use and HIV in either sex. These data indicate that illicit drug use is associated with altered HPG function in men and HIV infection is associated with altered HPG function in women. Furthermore, altered HPG function was associated with depressive symptoms in men, but not in women. Sex specific natural histories of illicit drug use and HIV infection, as they relate to endocrine and mental health, suggest a potential role for sex specific treatments to ameliorate these problems. The present data support recommendations of The National Academy of Science to consider gender differences in medical research.