A Closer Look at Depression and Its Relationship to HIV Antiretroviral Adherence

Abstract

Background Depression consistently predicts nonadherence to human immunodeficiency virus (HIV) antiretroviral therapy, but which aspects of depression are most influential is unknown. Such knowledge could inform assessments of adherence readiness and the type of depression treatment to utilize. Purpose We examined how depression severity, symptom type and change over time relate to adherence. Methods Microelectronic adherence and self-reported depression data from 1374 participants across merged studies were examined with cross-sectional and longitudinal analyses. Depression variables included a continuous measure, categorical measure of severity, cognitive and vegetative subscales, and individual symptoms. Results At baseline, mean adherence was 69%, and 25% had mild/moderate and 18% had severe depression. In cross-sectional multivariate analyses, continuous depression, cognitive depressive symptoms and severe depression were associated with lower adherence. In longitudinal analysis, reductions in both continuous and categorical depression predicted increased adherence. Conclusions The relationship between global continuous depression and nonadherence was statistically significant, but relatively weak compared to that of cognitive depressive symptoms and severe depression, which appear to pose strong challenges to adherence and call for the need for early detection and treatment of depression.

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

“…68 Logistical barriers such as forgetting medication doses, [65][66][67] travel, 66 and inconvenience/inconsistent routine 66,67 commonly affect adherence in youth. Psychological barriers including depression/ anxiety, [69][70][71][72] perceived stigma, 69 lack of support, 72-74 behavioral and conduct problems 71 are present in more than 50% of HIV-infected youth. 75 …”

Kepatuhan Berobat pada Pasien Asma Tidak Terkontrol dan Faktor-Faktor yang Berhubungan

“…Depresi dapat menghambat kepatuhan dan perilaku kesehatan lainnya, dan ketidakpatuhan dapat berefek pada kesehatan fisik yang dapat meningkatkan risiko untuk depresi. 54 Analisis bivariat hubungan sediaan obat yang digunakan dengan kepatuhan berobat pasien asma tidak terkontrol didapatkan tidak bermakna. Suatu tinjauan sistematik oleh Bender dkk, mengenai metode pemberian obat dan hubungannya dengan kepatuhan didapatkan bahwa pasien lebih patuh terhadap obat asma oral dibandingkan dengan obat hirup.…”

Non–Adherence to Antiretroviral Treatment by People Living with HIV/AIDS in Black Communities in South Africa: Socio-Cultural Challenges

“…HIV/AIDS patients who experience anxiety and forgetfulness tend to overlook their psychological wellbeing and eventually become depressed (Kilbourne, Reynolds, Good, & Sereika, 2005;Wagner, Googins, Remien, Rosen, Simoni, Bangsberg & Liu, 2011). They may be overwhelmed by helplessness and hopelessness, become withdrawn, be emotionally detached and be preoccupied with suicidal ideation (Kagee, 2007).…”