Associations between antiretroviral therapy-related experiences and mental health status among people living with HIV in China: a prospective observational cohort study

Abstract

Background Mental health problems (e.g., depression and anxiety) are among the most commonly reported comorbidities of HIV. Antiretroviral therapy (ART) coverage has increased sharply. The purposes of this prospective cohort study were to investigate the ART-related experiences and whether they were associated with mental health problems among a sample of people living with HIV undergoing ART in China. Methods The participants were 400 people living with HIV who had started ART for the first time in Guangzhou city. They were followed-up 1-year after ART initiation. Probable depression and moderate/severe anxiety were measured at baseline and Month 12, while experiences related to ART (e.g., side effects and regained self-confidence) were measured at Month 6. Univariate and multivariate logistic regressions were used to explore the associations between baseline characteristics, ART-related experiences and mental health status. Results Among the 300 participants (75.0%) who completed all three surveys, a significant decline in prevalence of probable depression (23.0% at baseline vs. 14.0% at Month 12, P = 0.002) and moderate/severe anxiety (14.7% at baseline vs. 8.7% at Month 12, P = 0.023) was observed during the follow-up period. After adjustment for mental health status and potential confounders at baseline, a number of ART-related experiences at Month 6 were associated with probable depression and/or moderate/severe anxiety measured at Month 12. Improved physical health, relationships with sexual partners, and self-confidence were associated with decreased mental health issues, while the side effects of ART, AIDS-related symptoms, and inconvenience in daily life due to ART use were associated with increased mental health issues. Conclusions ART-related experiences were associated with mental health problems, tailored mental health promotion interventions targeting these experiences are needed.

Relationships Among Trajectories of Sleep Disturbance, Depression, and Antiretroviral Therapy in Persons Newly Diagnosed with HIV: A One-and-a-Half-Year Observational Longitudinal Study

“…12,[14][15][16][17][18] In addition, the findings in the current study were similar to the results reported in China, which showed that the level of depression decreased from 23.0% at baseline to 14.0% at month 12 posttreatment. 11 Also consistent with a prospective observational study conducted by Downing et al, 12 the result showed that two sleep quality trajectory groups (bad sleep quality maintained and sleep quality negative change) were highly associated with depression. This suggests that screening for sleep quality and mental health problems is greatly warranted for PLWH who have new HIV diagnoses.…”

“… 9 Consecutive care with rolling adjustments based on the patients’ health status and good compliance with ART for PLWH might improve their mental health and sleep quality. 11 However, a recent study observed that after 9 months of follow-up, the sleep quality of most men who have sex with men (MSM) and bisexual men who live with HIV did not change. Only 17% of them improved, and 10% of the subjects have lower sleep quality.…”

Depression-Mediating Pathways From Household Adversity to Antiretroviral Therapy Nonadherence Among Children and Adolescents Living With HIV in Zambia: A Structural Equation Modeling Approach

“…It is unclear, therefore, whether endorsed anhedonia reflects underlying psychological distress or physical manifestations of poor health, whether related to chronic HIV infection or ART side effects. [41][42][43] Future studies should qualitatively elucidate idioms of psychological distress and manifestations of depressive processes in CALWH.…”

Perceptions toward antiretroviral therapy and delayed ART initiation among people living with HIV in Changsha, China: mediating effects of treatment willingness

“…The attitude and knowledge of clinicians ( 15 ), the interface of services between facilities, and limited resources have been reported as external factors affecting ART initiation ( 16 , 17 ). Patients’ personal factors may also contribute to delayed initiation, such as demographic factors including low income, low education, and lack of household decision-making power ( 18 ), HIV-related characteristics ( 14 ), mental health ( 19 , 20 ), and perceptions toward ART ( 21 ). Patients’ willingness to start treatment also influences the decision of ART initiation ( 22 ).…”