Depression in people living with HIV in sub-Saharan Africa: time to act (original) (raw)
Related papers
HIV and Depression: A Scoping Review of the South African Literature
New Voices in Psychology, 2017
This scoping review attempts to contextualise the current state of research regarding responding to co-morbid depression and HIV in primary healthcare, identify the gaps in research and develop appropriate recommendations. The researcher used Arksey and O’Malley’s six-stage scoping review method. The researcher reviewed articles from Springer Link, Ebsco Host, Pub Med and Psych Info that were found using the keywords ‘depression’; ‘HIV’; and ‘primary healthcare’ and that were published between 2010 and 2015. A final number of 27 articles were included in the scoping review. The review found that symptoms of depression in HIV positive patients can have a detrimental effect on their health-seeking behaviour and disease progression. Patients often do not report psychological symptoms of depression, unless enquired into, and usually focus on their physical symptoms. Additionally, there is a clear relationship between depression and antiretroviral treatment non-adherence and that treatin...
Systematic Reviews, 2021
Background Depression is one of the most prevalent mental disorders among an estimated 25.6 million people living with HIV (PLHIV) in sub-Saharan Africa (SSA). The depression rate is higher in HIV-seropositive men who have sex with men (MSM) regardless of their sexual orientation, identity or romantic attraction. This is due to various types of stigma including HIV-related stigma, social stigma, self-stigma and mental health stigma. Opportunistic infections, unemployment, poverty and food insecurity also predispose HIV-seropositive MSM to depression. Moreover, depression in heterosexual and sexual minority groups challenges and additionally burdens SSA health care systems due to inadequate economic developments, lack of mental health professionals who specialise in the treatment of depression, few MSM-centred facilities, inadequate mental health infrastructure (hospitals and clinics) and complimentary resources. Although studies have highlighted links between mental health disorder,...
General Hospital Psychiatry, 2018
The burden of HIV infection is higher in Africa where 70% of people living with HIV (PLHIV) resides. Since depression can negatively impact the course of HIV infection, it is therefore important to accurately estimate its burden among PLHIV in the continent. Methods We searched multiple databases to identify articles published between January 2000 and February 2018, reporting the prevalence of (major) depressive disorders in PLHIV residing in Africa. We used a random-effects meta-analysis model to pool studies. Results Overall, 118 studies (60,476 participants, 19 countries) were included. There was no publication bias. The overall prevalence estimates of depressive disorders and probable major depressive disorders were 36.5% (95% CI 32.3-41.0; 101 studies) and 14.9% (12.1-17.9; 55 studies) respectively. The heterogeneity of the overall prevalence of depressive disorders was significantly explained by screening tool used, period (higher prevalence in recent studies) and distribution in sub-regions. The study setting, site, CD4 cell counts, age, sex, proportion of people with undetectable viral load were not sources of heterogeneity. Conclusions
2014
Objectives: Depressive disorders are a significant public health issue. They are prevalent, disabling, and often chronic, with a high economic burden to the society. Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 4 times higher than the general population. It's still questionable whether HIV related depression is clinically different from sero-positive patients without depression. Studies comparing the clinical features of depressed and non-depressed People Living with HIV/AIDs are limited, hence the need for this study. Methods: This was a hospital based, cross sectional, descriptive study of three hundred adult HIV/AIDS patients attending the HIV clinic of Kwara State specialist hospital, Sobi, Ilorin. The PHQ-9 was administered to the respondents to screen for depression. A pre-tested PHQ-9 questionnaire was used to collect data. Subject who scored one and more were assessed clinically for depression. The three keys of social determinants of depression (SDS) were assessed and the association with depression sought. Results: One hundred and seventy (56.7%) satisfied the criteria for a depressive disorder using the PHQ-9 score. Compared to non-depressed sero-positive patients, depressed HIV patients were more likely to be female, single, unemployed, with below average year of schooling, low social economic status, low social cohesion and more stressful life events. They are more prone to hopelessness, thought of taking life and plan to commit suicide. Conclusion: These findings, show that the clinical and associated features of depression differ between depressed and non-depressed sero-positive subjects, thus requiring different management.
Journal of Family Medicine and Primary Care, 2017
Introduction: Depression, being the most common neuropsychiatric complication of HIV, is also associated with increased health-care utilization, decreased quality of life (QOL), and poor adherence to antiretroviral therapy (ART). Depression is a multidimensional disorder affected by a variety of biological, psychological, and social determinants and this relation becomes more complicated in HIV patients. The current study therefore aimed to investigate the sociodemographic and clinical determinants of depression and assess difference in the QOL of HIV patients not having depression and those suffering from depression. Materials and Methods: A cross-sectional study was conducted at an ART center in a tertiary care hospital in HIV/AIDS patients of 18 years of age. Sociodemographic and clinical characteristics were studied, depression anxiety and stress scale-21 was used to assess depression, and QOL assessment was done using WHOQOL-HIV BREF questionnaire. Results and Conclusions: Out of 754 study subjects, 377, i.e., 50% suffered from depression and nearly 75.9% of them were in the age group of 25-44 years. The prevalence of depression was higher in females, illiterates, and unemployed HIV patients as compared to males, literates, and employed subjects, respectively. HIV patients who were depressed had significantly lower QOL than the subjects not suffering from depression, more so in the environment and social relationships domains.
Journal of the Association of Nurses in AIDS care, 2003
disorders are common among 20% to 32% of people with HIV disease but are frequently unrecognized. Major depression is a recurring and disabling illness that typically responds to medications, cognitive psychotherapy, education, and social support. A large percentage of the emotional distress and major depression associated with HIV disease results from immunosuppression, treatment, and neuropsychiatric aspects of the disease. People with a history of intravenous drug use also have increased rates of depressive disorders. Untreated depression along with other comorbid conditions may increase costly clinic visits, hospitalizations, substance abuse, and risky behaviors and may reduce adherence to treatment and quality of life. HIV clinicians need not have psychiatric expertise to play a major role in detecting, screening, treating, and preventing major depression. Screening tools improve case finding and encourage early treatment. Effective treatments can reduce major depression in 80% to 90% of patients. Clinicians who mistake depressive signs and symptoms for those of HIV disease make a common error that increases morbidity and mortality.
Research Square (Research Square), 2020
Background Living with HIV/AIDS is associated with negative emotional and bodily symptoms; however, there is paucity of data on the prevalence and associated factors depression among this population. This study investigate the prevalence and factors contributing to depression among HIV patients on anti-retroviral therapy (ART) in O.R. Tambo Eastern Cape, South Africa. Method This cross-sectional descriptive study involve 334 adults receiving ART in the two Community Health Centers in OR Tambo District, Eastern Cape, South Africa. The Beck's Depression Inventory (BDI-II) was used to collect data, in addition to a semi-structured questionnaire on coping mechanism and challenges in seeking help with depressive symptoms. Multiple logistic regression analysis were used to assess the factors associated with depression among the HIV patients. Results The prevalence of depression among the HIV patients receiving ART was 44%, and the majority of the patient's depression fall within the borderline and moderate threshold. The prevalence of depression was signi cantly highest among females (71.0%; p < 0.0003) and unemployed (73.0%; p < 0.0014) HIV patients. Participants not bene ting from any form of social grant exhibited higher prevalence of depression (79%). Race (p=0.590), age (p=0.338) and married participants (p=0.511) show no statistical signi cant association between HIV and depression. Unadjusted logistic regression model show being female (OR = 1.99, 95% CI: 1.23-3.23; p < 0.003) and unemployed (OR =1.73, 95% CI: 1.08-2.77; p < 0.014) were signi cantly associated with a likelihood of depression. Majority of the participants who could express their feelings of HIV disease and challenges in accessing ART felt more depressed (85%) compared to those who could not express their feelings. Conclusion The rate of depression among HIV/AIDS patients receiving ART is high. Early detection of depression and the challenges associated with accessing treatment and treating would help in improving the compliance to treatment as well as quality of life.
HIV-depression: A Shadow Over 90-90-90 UNAIDS Program
There are 36.9 million people living with HIV (PLWHIV) according to a 2017 WHO estimation; 70% of the affected population is living in low and middle-income countries (LMIC). Depression, alcohol/ substance abuse and neurocognitive deficit are the three most common psychiatric disorders found in PLWHIV in said countries. Depression is the most prevalent, with a rate over 30%. It is of high interest then, to study the way in which this high prevalence has an impact on initiatives for the prevention and treatment of HIV infection, such as the 90-90-90 program of UN-OMS. The way to do this, is to focus on the current state of the depression treatment cascade observed in PLWHIV, and its link with adherence to antiviral treatment 1 .