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It is not known how sleep disturbance might contribute to risk of depression in adults with HIV. The investigators addressed this question by using data from the Multicenter AIDS Cohort Study (MACS), which is a longitudinal study following men who have sex with men (MSM), some with HIV and others without HIV. Information on self reported sleep problems for greater than two weeks and increased depression symptoms using the CES-D screening tool provided baseline and data every 6 months over 12 years of follow-up. There were 1054 non-depressed men with HIV (age 48.2 years) and 1217 non-depressed men negative for HIV (age 47.9 years) who were studied over the time period. Sleep disturbance was associated with increased depression in men with HIV at 6 months and was significantly greater than in MSM men without HIV. Incidence of depressive symptoms over the 12-year period continued to show the same significant increase in those with sleep disturbance compared to those men without sleep disturbance. Persons with HIV and sleep disturbance are at a higher risk for depression. This relationship suggests the need to address the problem of sleep disturbance earlier before the risk of depression can increase.