Prevalence and correlates of depressive symptoms among adults living with HIV in rural Kilifi, Kenya

Nyongesa, Moses K.; Mwangi, Paul; Wanjala, Stanley W.; Mutua, Agnes M.; Newton, Charles R.; Abubakar, Amina

doi:10.1186/s12888-019-2339-5

Cited by 32 publications

(43 citation statements)

References 41 publications

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“…The differences in prevalence estimates could be due to the differences in the study setting and measures used. Compared to the prevalence of depressive symptoms among the general adult population living with HIV from our setting [51], we report a higher estimate among YLWH. .001 a -co-occurrence of positive screen for depressive and anxiety symptoms b − adjusted for sex, level of education, employment, death of parent(s) and negative life events (in the past 1 year) c − for this category, no participant screened positive for anxiety or comorbidity symptoms, hence predicted failure perfectly and consequently 80 observations were not used The relatively high proportion of depressive symptoms (12%) among HIV-uninfected peers from our setting cannot be ignored, especially since previous research from Kenya also documents a high proportion [56].…”

Section: Discussioncontrasting

confidence: 79%

Section: Discussioncontrasting

confidence: 71%

“…Item scores are summated to derive a total score that ranges between 12 and 48, higher scores indicating a greater level of perceived stigma. We have previously used this scale in our setting with good reliability alpha [51]. In the present study, this scale had good internal consistency alpha, 0.81 (95% CI 0.78, 0.84).…”

Section: Measures Administered Via Audio Computer-assisted Selfintervsupporting

confidence: 56%

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Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study

et al. 2021

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Background In sub-Saharan Africa, common mental disorders (CMDs) like depression and anxiety are under-investigated amongst young people living with HIV (YLWH). To address the gap, in Kenya we: a) determined the prevalence of CMDs among YLWH compared to their uninfected peers; b) investigated HIV status as an independent predictor of CMDs in young people; c) investigated CMDs risk and protective indicators with more focus on YLWH. Methods Between November 2018 and September 2019, 819 young people aged 18–24 years (407 HIV-infected) were recruited from two Counties on the Kenyan coast. Locally adapted pre-existing mental health measures, Patient Health Questionnaire (9-item) and Generalized Anxiety Disorder scale (7-item), were administered among other questionnaires via audio computer-assisted self-interview. Logistic regression was used to determine the correlates of CMDs. Results Prevalence of CMDs was significantly elevated among YLWH compared to their uninfected peers i.e. 29% vs. 12%; p < 0.001 for depressive symptoms, 19% vs. 8%; p < 0.001 for anxiety symptoms, and 16% vs. 5%; p < 0.001 for comorbid depressive and anxiety symptoms. HIV status independently predicted depressive symptoms and its co-occurrence with anxiety symptoms. Among YLWH, negative life events, higher perceived HIV-related stigma and low adherence to antiretroviral therapy were the risk indicators for elevated CMDs. Among HIV-uninfected youths, death of both parents was a risk indicator for elevated depressive symptoms. Protective indicators against CMDs among youths with and without HIV included higher social support and health-related quality of life. Conclusion At the Kenyan coast, YLWH have significantly higher burden of CMDs compared to their uninfected peers. Being HIV-positive as a youth in this setting is predictive of more depressive symptoms and its comorbidity with anxiety symptoms. YLWH at high risk of CMDs in coastal Kenya can benefit from early detection, referral and treatment if routine screening for CMDs is integrated in their care package. The mental wellbeing of bereaving HIV-unaffected youths could be improved through continued support to help them come to terms with their loss. At the community level, programmes strengthening the social capital or improving the overall quality of life of youths with or without HIV may be beneficial to their mental health.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussioncontrasting

confidence: 71%

Section: Measures Administered Via Audio Computer-assisted Selfintervsupporting

confidence: 56%

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Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study

et al. 2021

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“…We further assessed mental health status, using the PHQ-2 and PHQ-9 instruments. Although these tools have been validated in Ethiopia and East Africa, we found unexpectedly low rates of symptoms of depressive disorder in our population compared to previous studies among PLHIV in this region [34,69,70]. It is possible that the cut-off value (�3) used in the PHQ-2 was too insensitive for detecting major depressive disorder in this study population.…”

Section: Discussioncontrasting

confidence: 75%

Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia

et al. 2020

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Introduction The potential impact of socio-economic condition on virological suppression during antiretroviral treatment (ART) in sub-Saharan Africa is largely unknown. In this case-control study, we compared socio-economic factors among Ethiopian ART recipients with lack of virological suppression to those with undetectable viral load (VL). Methods Cases (VL>1000 copies/ml) and controls (VL<150 copies/ml) aged ≥15years, with ART for >6 months and with available VL results within the last 3 months, were identified from registries at public ART clinics in Central Ethiopia. Questionnaire-based interviews on socio-economic characteristics, health condition and transmission risk behavior were conducted. Univariate variables associated with VL>1000 copies/ml (p<0.25) were added to a multivariable logistic regression model. Results Among 307 participants (155 cases, 152 controls), 61.2% were female, and the median age was 38 years (IQR 32–46). Median HIV-RNA load among cases was 6,904 copies/ml (IQR 2,843–26,789). Compared to controls, cases were younger (median 36 vs. 39 years; p = 0.004), more likely to be male (46.5% vs. 30.9%; p = 0.005) and had lower pre-ART CD4 cell counts (170 vs. 220 cells/μl; p = 0.009). In multivariable analysis of urban residents (94.8%), VL>1000 copies/ml was associated with lower relative wealth (adjusted odds ratio [aOR] 2.98; 95% CI 1.49–5.94; p = 0.016), geographic work mobility (aOR 6.27, 95% CI 1.82–21.6; p = 0.016), younger age (aOR 0.94 [year], 95% CI 0.91–0.98; p = 0.011), longer duration of ART (aOR 1.19 [year], 95% CI 1.07–1.33; p = 0.020), and suboptimal (aOR 3.83, 95% CI 1.33–10.2; p = 0.048) or poor self-perceived wellbeing (aOR 9.75, 95% CI 2.85–33.4; p = 0.012), after correction for multiple comparisons. High-risk sexual behavior and substance use was not associated with lack of virological suppression. Conclusion Geographic work mobility and lower relative wealth were associated with lack of virological suppression among Ethiopian ART recipients in this predominantly urban population. These characteristics indicate increased risk of treatment failure and the need for targeted interventions for persons with these risk factors.

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“…The association between BMI and severe depressive symptoms in PLHIV is not systematically explored and makes no consensus [25,[59][60][61]. A low BMI could be an indirect marker of loss of appetite, one of the most reported symptoms in HIV related-depression.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with severe depressive symptoms in older west African people living with HIV

et al. 2020

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Background Depression is one of the most common psychiatric disorders in people living with HIV (PLHIV). Depression has a negative impact on both mental and physical health and is mainly associated with suboptimal HIV treatment outcomes. To encourage successful aging and the achievement of the 3 × 90 objectives in older PLHIV, the psychological domain must not be neglected. In this context and as data are scarce in West Africa, this study aimed to evaluate the prevalence and the factors associated with severe depressive symptoms in older PLHIV living in this region of the world. Methods Data from PLHIV aged ≥50 years and on ART since ≥6 months were collected in three clinics (two in Côte d’Ivoire, one in Senegal) participating in the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. The severity of depressive symptoms was measured using the Center for Epidemiological Studies Depression scale (CES-D), and associated factors were identified using logistic regressions. Results The median age of the 334 PLHIV included in the study was 56.7 (53.5–61.1), 57.8% were female, and 87.1% had an undetectable viral load. The prevalence of severe depressive symptoms was 17.9% [95% Confidence Interval (95% CI): 13.8–22.0]. PLHIV with severe depressive symptoms were more likely to be unemployed (adjusted Odd Ratio (aOR) = 2.8; 95% CI: 1.4–5.7), and to be current or former tobacco smokers (aOR = 2.6; 95% CI: 1.3–5.4) but were less likely to be overweight or obese (aOR = 0.4; 95% CI: 0.2–0.8). Conclusions The prevalence of severe depressive symptoms is high among older PLHIV living in West Africa. Unemployed PLHIV and tobacco smokers should be seen as vulnerable and in need of additional support. Further studies are needed to describe in more details the reality of the aging experience for PLHIV living in SSA. The integration of screening and management of depression in the standard of care of PLHIV is crucial.

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Prevalence and correlates of depressive symptoms among adults living with HIV in rural Kilifi, Kenya

Cited by 32 publications

References 41 publications

Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study

Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study

Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia

Prevalence and factors associated with severe depressive symptoms in older west African people living with HIV

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