Psychosocial Functioning and Depressive Symptoms Among HIV-Positive Persons Receiving Care and Treatment in Kenya, Namibia, and Tanzania

Abstract

In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIVattending HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Eighteen HIV care and treatment clinics (six per country) enrolled approximately 200 HIV-positive patients (for a total of 3,538 participants) and collected data on patients’ physical and mental well-being, medical/health status, and psychosocial functioning. Although the majority of participants did not report clinically significant depressive symptoms (72 %), 28 % reported mild to severe depressive symptoms, with 12 % reporting severe depressive symptoms. Regression models indicated that greater levels of depressive symptoms were associated with: (1) being female, (2) younger age, (3) not being completely adherent to HIV medications, (4) likely dependence on alcohol, (5) disclosure to three or more people (versus one person), (6) experiences of recent violence, (7) less social support, and (8) poorer physical functioning. Participants from Kenya and Namibia reported greater depressive symptoms than those from Tanzania. Approximately 28 % of PLHIV reported clinically significant depressive symptoms. The scale-up of care and treatment services in sub-Saharan Africa provides an opportunity to address psychosocial and mental health needs for PLHIV as part of comprehensive care.

Social Acceptance for Patients Infected with Human Immunodeficiency Virus in Kerman and Rafsanjan, Iran

“…The greater social acceptance of females than males may be due to the entrance of more females into universities and high levels of education, knowledge, and social relations in the last decades in Iran. In contrast, additional studies conducted in Tanzania, Namibia and Kenya indicated that higher levels of depressive symptoms were associated with being female (12). Another study indicated that males experienced greater acceptance than females (13).…”

Evaluating mental health difficulties and associated outcomes among HIV-positive adolescents in Tanzania

“…Further, adolescents with HIV may experience higher rates of depression, anxiety, and traumatic experiences than their uninfected peers (T. Betancourt et al, 2014; Kamau, Kuria, Mathai, Atwoli, & Kangethe, 2012; Seth et al, 2014). Despite these statistics, mental health research and services are scarce for HIV-positive youth, especially in low-resource settings (Klasen & Crombag, 2012; Patel, Flisher, Nikapota, & Malhotra, 2008; Thapar, Collishaw, Pine, & Thapar, 2012).…”

Social Support, Stigma and Antenatal Depression Among HIV-Infected Pregnant Women in South Africa

“…In addition, recent evidence suggests that psychosocial factors and depression are interrelated. Studies conducted in sub-Saharan Africa have identified associations between depressive symptoms and both low levels of social support [15] and high levels of HIV-related stigma [16, 17], and recent research conducted among HIV-infected men and women in South Africa has reported that both HIV-related stigma and social support are independently associated with depression [18]. However, the interrelationships among these constructs are poorly understood, and most previous research has not explored the potentially moderating effect of these factors on the relationships between other factors and depression.…”