A Marginal Structural Model to Estimate the Causal Effect of Antidepressant Medication Treatment on Viral Suppression among Homeless and Marginally Housed Persons Living with HIV

摘要

contextDepression strongly predicts non-adherence to HIV antiretroviral therapy, and adherence is essential to maintaining viral suppression. This suggests that pharmacologic treatment of depression may improve virologic outcomes. However, prior longitudinal observational analyses have inadequately adjusted for time-varying confounding by depression severity, which could yield biased estimates of treatment effect. Application of marginal structural modeling to longitudinal observation data can, under certain assumptions, approximate the findings of a randomized controlled trial.