Levels of self-reported depression and anxiety among HIV-positive patients in Albania: a cross-sectional study

Abstract

AimTo gain an initial perspective of mental health issues facing the Human Immunodeficiency Virus (HIV)-positive population at the University Hospital Center of Tirana (UHCT) HIV/AIDS Ambulatory Clinic.MethodsFrom June-August 2009, we conducted semi-structured interviews with 79 patients (93% response rate) at the UHCT HIV/AIDS Ambulatory Clinic. The interviews assessed patient-reported histories of mental health diagnoses, patients’ demographics, and current emotional health status.ResultsThe percentage of patients who reported a history of diagnosis of depression or anxiety was high – 62.3% and 82.3%, respectively. Factors associated with a history of depression included having been diagnosed with anxiety (P < 0.001), having a higher number of barriers to care (P < 0.001), having a higher number of current medical and social needs (P < 0.001), or having not obtained antiretroviral therapy (ART) abroad (P = 0.004). Factors associated with a history of anxiety included having been on first-line ART (P = 0.008), having been diagnosed with HIV for shorter periods of time (P = 0.043), having been diagnosed with depression (P < 0.001), having a higher number of current medical and social needs (P = 0.035), or having not obtained ART abroad (P = 0.003).ConclusionsMental health problems are widespread among the known HIV-positive patient population in Albania. The high prevalences of anxiety and depression and of dual diagnoses of these conditions suggest the need for more mental health care for HIV-positive patients in Albania.

Antiretroviral therapy adherence and predictors to adherence in Albania: a cross-sectional study

“…Many challenges face patients that are seeking care for HIV/AIDS in Albania, yet this study evidences that once patients reach care, adherence to ART is high [10,13,14,[16][17][18]47]. Factors contributing to poor medication adherence include being partnered, mental health issues, higher levels of barriers to care, and higher current medical and social needs.…”

“…Albania's HIV prevalence is < 0.1%, as reported by the Albanian Ministry of Health (MoH); through 2013, 671 cumulative HIV cases were reported in Albania [7][8][9]. However, the MoH acknowledges the prevalence is likely higher, and a molecular epidemiological study suggests the prevalence may be as high as 1.3% or 150-fold that of current estimates [10][11][12][13][14][15][16][17][18]. The predominant strain of HIV in Albania is HIV-1A, which differs from the many surrounding countries, including Greece, Italy, Serbia, and Montenegro, where epidemics are being driven by HIV-1B [11,19].…”

“…Each index was then treated as a continuous variable in analysis. The development of the indices along with their parameters was described previously [10,47]. SAS 9.1.3 was used to analyze the data.…”

“…Other parts of the survey used in this study along with the steps taken to ensure proper translation into Albanian were described previously [10,47]. The adherence section of the survey was adapted from the survey on adherence from the AIDS Clinical Trials Group (ACTG) (Appendix 1) [48].…”

“…The study was undertaken at the University Hospital Center of Tirana (UHCT) HIV/AIDS Ambulatory Clinic, as previously described [10,47]. Since 2004 this clinic has been the sole site offering ART in Albania [13].…”