The association between depression and adherence to antiretroviral therapy in HIV-positive patients, KwaZulu-Natal, South Africa

Kitshoff, Chelline; Campbell, Laura; Naidoo, Soornarain S

doi:10.1080/20786204.2012.10874194

Cited by 26 publications

(30 citation statements)

References 36 publications

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“…(25) Based on western countries studies, older PLHIV had to face different type of problems: stigma (26) and concerns about disclosure. In accordance with other studies conducted in middle-aged PLHIV living in SSA, (29,30) poor social conditions seem to be an important factor associated with depressive symptoms. In South Africa, it was shown that unemployed PLHIV could have a 3-fold risk to present severe depressive symptoms.…”

Section: Discussionsupporting

confidence: 91%

Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV: the West Africa IeDEA collaboration

Bernard

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Diallo

et al. 2020

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Background To encourage successful aging, the psychological domain must not be neglected. As depression, one of the most common psychiatric disorders in PLHIV, has negative impact on both mental and physical health, the prevalence and the factors associated with the presence of severe depressive symptoms in older PLHIV living in West Africa need to be well understood. Methods Data from PLHIV aged ≥50 years old and on ART since ≥6 months were collected in three clinics (two in Côte d’Ivoire, one in Senegal) participating to the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. The severity of the depressive symptoms was measured using the Center for Epidemiological Studies Depression scale (CES-D) and associated factors were identified using logistic regression. Results The median age of the 334 PLHIV included in the study was 56.7 (53.5-61.1) years old, 57.8% were female and 87.1% had an undetectable viral load. The prevalence of severe depressive symptoms was 17.9% [95% Confidence Interval: 13.8 - 22.0]. PLHIV with severe depressive symptoms were more likely to have no professional activity, and to be current or former tobacco smokers but were less likely to be overweight or obese. Conclusions The prevalence of severe depressive symptoms is high among older PLHIV living in West Africa. How to integrate the measurement and the management of depressive symptoms in the standard of care should be investigated, both for older PLHIV on ART but also for newly diagnosed older patients, in order to achieve the 90-90-90 objectives.

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Section: Discussionsupporting

confidence: 91%

Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV: the West Africa IeDEA collaboration

Bernard

Font

Diallo

et al. 2020

Preprint

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“…Compared to middle-aged PLHIV (median age <45 years, 200 PLHIV included), and when using also the CES-D and the same cut-off as in our study, a prevalence of 18% was observed in Senegal (47). In Nigeria and South Africa, using CES-D but with a cut off ≥16, the prevalence of severe depressive symptoms in middle-aged PLHIV (mean age <45 years) on ART for at least six months was similar or higher (21 % to 62%) (23,48,49). In this context, we cannot conclude that older PLHIV are more likely to have severe depressive symptoms than younger ones.…”

Section: Discussionsupporting

confidence: 68%

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

Bernard

Font

Diallo

et al. 2020

Preprint

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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 3x90 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 West Africa. 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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“…Based on the 20-item CES-D (cut-off≥16), the pooled prevalence of depressive symptoms among untreated or mixed groups of PLHIV was 31% [95% CI: 30–33] with a high between-group heterogeneity (I 2 = 98%) (Fi 3A-right) [ 22 , 23 , 45 – 47 ]. Among the PLHIV on ART and based on the 20-item CES-D (cut-off≥16), the pooled prevalence of depressive symptoms was 32% [95% CI: 28–35] with a high between-group heterogeneity (I 2 = 97%) ( Fig 3A -left) [ 36 , 42 – 44 ]. In Poupard et al, different cut-off points were used for men (≥17) and women (≥23) [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…In PLHIV on ART, the severity of depressive symptoms seemed unrelated to CD4 level [ 43 , 44 ], except in one [ 76 ]; whereas in another publication [ 52 ] a negative relationship was observed. Severity of depressive symptoms could be related to age [ 76 ] or low level of education [ 44 ] whereas no effect of gender was observed [ 42 , 53 , 76 ]. PLHIV with no more than primary school education seemed to have nearly a 2-fold risk of having more depressive symptoms [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Severity of depressive symptoms could be related to age [ 76 ] or low level of education [ 44 ] whereas no effect of gender was observed [ 42 , 53 , 76 ]. PLHIV with no more than primary school education seemed to have nearly a 2-fold risk of having more depressive symptoms [ 44 ]. Stigma [ 53 ], unemployment and lower income [ 44 , 76 ] seemed to be associated with severe depressive symptoms.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: A systematic review and meta-analysis

2017

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Depression, one of the most common psychiatric disorders, is two- to three-times more prevalent in people living with HIV (PLHIV) than in the general population in many settings as shown in western countries but remains neglected in sub-Saharan Africa (SSA). We aimed to summarize the available evidence on the prevalence of depression and associated factors according to the scales used and the treatment status in PLHIV in SSA. The pooled prevalence estimates of depression ranged between 9% and 32% in PLHIV on antiretroviral treatment (ART) and in untreated or mixed (treated/untreated) ones, with a substantial variability according to the measurement scale used and also for a given scale. Low socio-economic conditions in PLHIV on ART, female sex and immunosuppression in mixed/untreated PLHIV were frequently reported as associated factors but with no consensus. As depression could have deleterious consequences on the PLHIV life, it is critical to encourage its screening and management, integrating these dimensions in HIV care throughout SSA.

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The association between depression and adherence to antiretroviral therapy in HIV-positive patients, KwaZulu-Natal, South Africa

Cited by 26 publications

References 36 publications

Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV: the West Africa IeDEA collaboration

Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV: the West Africa IeDEA collaboration

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

Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: A systematic review and meta-analysis

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