--- title: >- Estimating the Effect of Depression on HIV Transmission Risk Behaviors Among People Who Inject Drugs in Vietnam: A Causal Approach description: >- Explore this publication on real-world evidence: Estimating the Effect of Depression on HIV Transmission Risk Behaviors Among People Who Inject Drugs in… date: '2020-01-01' author: Sara N. Levintow category: Publications tags: - HIV - University of North Carolina at Chapel Hill - Approval & Commercialization - AIDS and Behavior - 'Yes' - Johns Hopkins Bloomberg School of Public Health - Health System Partner - Centers for Disease Control and Prevention - Oral Presentation - UNC Project Vietnam - Methods/Pharmacoepi - R&D canonical_url: >- https://www.headwaterscience.com/resources/publications/di-hiv/estimating-the-effect-of-depression-on-hiv-transmission/ source: Headwater Science license: © 2026 Headwater Science. All rights reserved. slug: estimating-the-effect-of-depression-on-hiv-transmission id: 3GhGizO6afEL9i4LgeaZvI contentType: article --- ## Challenge Among people who inject drugs in Vietnam—where depression is highly prevalent and HIV incidence remains elevated—the causal effect of depression on injection equipment sharing and sexual risk behaviors had not been estimated using modern causal inference methods. ## Solution Target RWE researchers and UNC/CDC collaborators applied marginal structural models and causal inference methods to longitudinal data from 455 PWID living with HIV in Vietnam to estimate the causal effect of depressive symptoms on risk behaviors over time. ## Impact Demonstrating that severe depression increases injection equipment sharing among PWID provides causal evidence for the HIV prevention value of depression treatment, informing integrated HIV/mental health intervention design in Southeast Asia. ## Use Cases / Links Causal HIV transmission risk behavior evidence for depression intervention design in PWID populations, Integrated HIV/mental health intervention evidence for Southeast Asia prevention programs