{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:28:55Z","timestamp":1773278935415,"version":"3.50.1"},"reference-count":55,"publisher":"American Public Health Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p> Objectives. We assessed whether directly observed fluoxetine treatment reduced depression symptom severity and improved HIV outcomes among homeless and marginally housed HIV-positive adults in San Francisco, California, from 2002 to 2008. <\/jats:p><jats:p> Methods. We conducted a nonblinded, randomized controlled trial of once-weekly fluoxetine, directly observed for 24 weeks, then self-administered for 12 weeks (n\u2009=\u2009137 persons with major or minor depressive disorder or dysthymia). Hamilton Depression Rating Scale score was the primary outcome. Response was a 50% reduction from baseline and remission a score below 8. Secondary measures were Beck Depression Inventory-II (BDI-II) score, antiretroviral uptake, antiretroviral adherence (measured by unannounced pill count), and HIV-1 RNA viral suppression (&lt;\u200950 copies\/mL). <\/jats:p><jats:p> Results. The intervention reduced depression symptom severity (b\u2009=\u2009\u22121.97; 95% confidence interval [CI]\u2009=\u2009\u22120.85, \u22123.08; P\u2009&lt;\u2009.001) and increased response (adjusted odds ratio [AOR]\u2009=\u20092.40; 95% CI\u2009=\u20091.86, 3.10; P\u2009&lt;\u2009.001) and remission (AOR\u2009=\u20092.97; 95% CI\u2009=\u20091.29, 3.87; P\u2009&lt;\u2009.001). BDI-II results were similar. We observed no statistically significant differences in secondary HIV outcomes. <\/jats:p><jats:p> Conclusions. Directly observed fluoxetine may be an effective depression treatment strategy for HIV-positive homeless and marginally housed adults, a vulnerable population with multiple barriers to adherence. <\/jats:p>","DOI":"10.2105\/ajph.2011.300422","type":"journal-article","created":{"date-parts":[[2012,6,21]],"date-time":"2012-06-21T22:44:13Z","timestamp":1340318653000},"page":"308-315","source":"Crossref","is-referenced-by-count":68,"title":["Directly Observed Antidepressant Medication Treatment and HIV Outcomes Among Homeless and Marginally Housed HIV-Positive Adults: A Randomized Controlled Trial"],"prefix":"10.2105","volume":"103","author":[{"given":"Alexander C.","family":"Tsai","sequence":"first","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan H.","family":"Karasic","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwendolyn P.","family":"Hammer","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin D.","family":"Charlebois","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Ragland","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew R.","family":"Moss","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L.","family":"Sorensen","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James W.","family":"Dilley","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Bangsberg","sequence":"additional","affiliation":[{"name":"At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.58.8.721"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2011.04.002"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050225"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.20.2492"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.13.1454"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181b720e7"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-008-0025-1"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318201df63"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181b18b6e"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283463f09"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr209"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.2.217"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510210054027"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(96)00064-6"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.7.1133"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.180109"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-007-0026-5"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.182022"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2003.20938.x"},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.58.8.729"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.1037\/a0012715"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.160"},{"issue":"1","key":"bib23","first-page":"23","volume":"171","author":"Pyne JM","year":"2011","journal-title":"Arch Intern Med"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2006.090209"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.0282.x"},{"issue":"12","key":"bib26","first-page":"1145","volume":"79","author":"Farmer P","year":"2001","journal-title":"Bull World Health Organ"},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03520060055032"},{"key":"bib28","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.7.1207"},{"key":"bib29","volume-title":"Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I\/P)","author":"First MB","year":"2002"},{"key":"bib30","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition","year":"1994"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.5.697"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"bib33","unstructured":"Guy W.Early Clinical Drug Evaluation Unit Assessment Manual for Psychopharmacology\u2013Revised.Rockville, MD:US Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Psychopharmacology Research Branch, Division of Extramural Research Programs;1976.DHEW publication ADM76\u2013338."},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1991.01810330075011"},{"key":"bib35","volume-title":"Manual for Beck Depression Inventory II (BDI-II)","author":"Beck A","year":"1996"},{"key":"bib36","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200003100-00008"},{"key":"bib37","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988","edition":"2"},{"key":"bib38","doi-asserted-by":"publisher","DOI":"10.3102\/10769986024001070"},{"key":"bib39","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.14.1840"},{"key":"bib40","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.071068"},{"key":"bib41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050237"},{"key":"bib42","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.2.191"},{"key":"bib43","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(01)80109-0"},{"key":"bib44","doi-asserted-by":"publisher","DOI":"10.1097\/00004850-200503000-00001"},{"key":"bib45","doi-asserted-by":"publisher","DOI":"10.1086\/521166"},{"key":"bib46","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000434"},{"key":"bib47","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.61.10.1042"},{"key":"bib48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030438"},{"key":"bib49","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.536"},{"key":"bib50","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0009479"},{"key":"bib51","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.4.311"},{"key":"bib52","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39524.439618.25"},{"key":"bib53","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1638-4"},{"key":"bib54","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.3.469"},{"key":"bib55","doi-asserted-by":"publisher","DOI":"10.1177\/0269881108089585"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2011.300422","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T23:15:12Z","timestamp":1652138112000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2011.300422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2]]},"references-count":55,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,2]]}},"alternative-id":["10.2105\/AJPH.2011.300422"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2011.300422","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2]]}}}