Depression and anxiety were low amongst virally suppressed, long-term treated HIV-infected individuals enrolled in a public sector antiretroviral program in Thailand

Abstract

HIV/AIDS and anxiety/depression are interlinked. HIV-infected patients suffering from depression may be at risk for poor adherence which may contribute to HIV disease progression. Additionally, an HIV diagnosis and/or using certain antiretroviral agents may trigger symptoms of anxiety/depression. The objective of the study was to assess the prevalence and factors associated with anxiety and depression in HIV-infected patients from the Thai National HIV Treatment Program. This cross-sectional study was performed from January 2012 to December 2012 in HIV-infected out-patients, aged ≥18 years, from three HIV referral centers. Symptoms of anxiety and depression were measured using the Thai-validated Hospital Anxiety and Depression Scale (HADS). A score of ≥11 was defined as having anxiety and depression. Associated factors were assessed by multivariate logistic regression. Totally 2023 (56% males) patients were enrolled. All patients received antiretroviral therapy (ART) for a mean duration of 7.7 years. Median CD4 was 495 cells/mm. Ninety-five percent had HIV-RNA < 50 copies/ml. Thirty-three percent were currently on efavirenz (EFV)-based ART. The prevalence of anxiety and depression were 4.8% and 3.1%, respectively. About 1.3% had both anxiety and depression. In multivariate logistic models, the female sex [OR = 1.6(95%CI 1.1-2.3), p = .01], having adherence <90% [OR = 2.2(95%CI 1.5-3.4), p < .001], fair/poor quality of life (QOL) [OR = 7.2 (95%CI 3.6-14.2), p < .001] and EFV exposure [OR = 1.6(95%CI 1.1-2.3), p = .01], were independently associated with having anxiety or depression. Our findings demonstrated that prevalence of depression and anxiety was low amongst virally suppressed, long-term antiretroviral-treated HIV-infected individuals. Some key characteristics such as the female sex, poor adherence, poor/fair QOL and EFV exposure are associated with anxiety and depression. These factors can be used to distinguish who would need a more in-depth evaluation for these psychiatric disorders.

Assessing the measurement invariance of the CESD-10 and Beck anxiety inventory (BAI) questionnaires across people living with HIV/AIDS and healthy people

“…Contrary to our expectations, this study showed that no significant difference was observed in anxiety scores of PLWHAs and healthy individuals. Although this result differs from some published studies which reported that anxiety was higher in PLWHAs as opposed to general population (1-3, 6, 14, 49), it is consistent with other studies such as Prasithsirikul et al (2017) and Sewell et al (2000) (28,52).…”

“…These contradictions in the results could be attributed to a variety of populations and instruments applied in different studies to ascertain the diagnosis of psychological disorders. One possible explanation for our findings might be that the mean duration of living with HIV in our sample was 5.52 ± 3.43 which is somehow a lengthy period in which PLWHAs have acquired skills to adapt to living with HIV so that they may no longer be afraid of dying from HIV (28,52).…”

“…In general, the prevalence rate of depression and anxiety has been estimated from 3.2-45% and from 1.27-53% among PLWHAs, respectively. (2,9,12,27,28). This diversity in prevalence rates can be contributed to various patients in different studies, research settings and more importantly the methods and criteria used for the assessment and diagnosis of depression and anxiety.…”

Dual burden: the experience of depression among women living with HIV in Ethiopia- a qualitative study

“…Low awareness, lack of mental health policy, and lower health service utilization were accounted as the main barriers for mental health service in the country (7). This issue has drawn tremendous public health attention for the last ve years and there has been a wide-ranging interest to generate evidence on the comorbidity of depression and HIV (8)(9)(10)(11). However, very limited studies do exist and an increasing concern in resource-limited developing countries of the world where people living with HIV do not get an early mental health screening (12), awareness and linking to mental health service to the same level in developed countries, and the impact on daily life is still growing (13).…”

Dual Burden: The Experience of Depression Among Women Living With HIV in Ethiopia- a Qualitative Study

“…This issue has drawn a tremendous public health attention for the last ve years and there has been wide-ranging interest on the need to generate evidence on the subject matter related to the comorbidity of depression and HIV (8)(9)(10)(11). However, very limited studies do exist and an increasing concern in resourcelimited developing countries of the world where people living with HIV do not get an early mental health screening (12), awareness and linking to mental health service to the same level in developed countries, and the impact on daily life is still growing (13).…”