Anxiety and Depression Symptoms as Risk Factors for Non-adherence to Antiretroviral Therapy in Brazil

Abstract

Depression and anxiety are common among HIV-infected people and rank among the strongest predictors of non-adherence to antiretroviral therapy (ART). This longitudinal study aimed to assess whether symptoms of anxiety and depression are predictors of non-adherence among patients initiating ART at two public referral centers (n=293) in Belo Horizonte, Brazil. Prevalence of severe anxiety and depression symptoms before starting ART was 12.6% and 5.8%, respectively. Severe anxiety was a predictor of non-adherence to ART during follow-up period (RH=1.87; 95% CI=1.14-3.06) adjusted for low education, unemployment, alcohol use in the last month and symptoms of AIDS; while a history of injection drug use had borderline statistical significance with non-adherence. These findings suggest that using a brief screening procedure to assess anxiety and depression symptoms before initiating ART help identify individuals for interventions to improve adherence and quality of life.

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

“…This is consistent with observations in resourcerich settings (Boarts et al 2006;Gibbie et al 2007;Turner et al 2003;Villes et al 2007;Vranceanu et al 2008) and resource-limited settings Campos et al 2008;Pina Lopez et al 2008;Poupard et al 2007). In a meta-analysis of the effects of depression and anxiety on patient adherence, depressed patients had three times the odds of noncompliance compared to non-depressed patients (DiMatteo et al 2000).…”

The influence of depressive symptoms and substance use on adherence to antiretroviral therapy. A cross-sectional prevalence study

“…(25%) in 322 healthcare clinics in Brazil, 28 but lower than what was observed in other Brazilian studies (36.9% and 37.2%), 21,22 with different methodologies. In a randomized controlled trial, the percentages of non-adherence measured by means of Medication Event Monitoring System (MEMS) caps ranged from 35.4% to 50.9%, 29 which was similar to the results for past non-adherence in the present study.…”

Distress Tolerance, Emotion Dysregulation, and Anxiety and Depressive Symptoms Among HIV+ Individuals

“…The empirical literature documents statistically and clinically significant relations between HIV/AIDS and anxiety and depressive symptoms and disorders (Bing et al 2001;Campos et al 2010;Olley et al 2005). Rates of anxiety disorders among HIV?…”