Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

Stockton, Melissa; Hosseinipour, Mina C.; Pettifor, Audrey; Maselko, Joanna; Mphonda, Steven M.; Kulisewa, Kazione; Udedi, Michael; Pence, Brian W.

doi:10.1007/s10461-020-03041-7

Cited by 11 publications

(9 citation statements)

References 54 publications

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“…Our finding that an HIV positive test result was significantly associated with increased odds of reporting depression symptoms contributes to the evidence asserting that depression is common and higher among people living with HIV compared to the general population (Bernard et al, 2017, August;Bigna et al, 2019;Lofgren et al, 2020;Stockton et al, 2020). In our study, a third (29.4%) of people reporting HIV positive test results reported depression symptoms compared to nearly one in five (18.1%) with an HIV negative test result.…”

Section: Discussionsupporting

confidence: 67%

“…Mental health difficulties, including major depressive disorders (MDD) and disability, constrain the quality of life for people living with HIV and reduce their ability to benefit from HIV services and are often used as a proxy for quality of life. A study in Malawi found a prevalence of depression of 27% among adults initiating ART (Stockton et al, 2020). In Botswana, Gupta and colleagues found in a population-based study that 30% of men and 25% of women living with HIV screened positive for depression (Gupta et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Facing the quality of life: physical illness, anxiety, and depression symptoms among people living with HIV in rural Zambia – a cross-sectional study

et al. 2021

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Widespread access to ART has not improved the quality of life (QoL) for people living with HIV (PLHIV). We used the United Nations Disability project (UNPRPD) evaluation data to examine how physical illness, anxiety, and depression shape the QoL of PLHIV in households receiving the social cash transfers safety nets in Luapula, Zambia. We explored associations between each outcomephysical illness, anxiety, depression symptomsand age, gender, poverty, hunger and disability, using univariable and multivariable regressions. We adjusted p-values for multiple hypothesis testing with sharpened Qs. The sample comprised 1925 respondents 16-55 years old, median age 31 (IQR 22-42 years), majority women (n = 1514, 78.6%). Two-thirds (1239, 64.4%) reported having a physical illness, a third (671, 34.9%) anxiety, and nine per cent (366) depression symptoms. More HIV positive people had a disability (34.6%, 53 versus 28.3%, 502; Q = 0.033), were physically ill (72.5%, 111 versus 63.7%, 1128; Q = 0.011), and two-fold (aOR 1.97 95% CI 1.31-2.94) more likely to report depression symptoms than HIV negative peers. Food insecurity and disability among PLHIV may worsen their physical illnesses, anxiety, depression symptoms, and other QoL domains. More research on the quality of life of PLHIV in poverty is required.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Facing the quality of life: physical illness, anxiety, and depression symptoms among people living with HIV in rural Zambia – a cross-sectional study

et al. 2021

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“…Previous studies have reported the presence of depression in a higher percentage of patients, and the presence of constitutional symptoms in these patients may be one of the reasons for over-reporting of depression in these patients. [ 11 16 17 25 26 ]…”

Section: Discussionmentioning

confidence: 99%

Is International HIV Dementia Scale good enough to diagnose HIV-associated neurocognitive disorders?

Himanshu

Tandon

Kumar

et al. 2022

Journal of Family Medicine and Primary Care

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Introduction: Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) comprise impairment of multiple cognitive domains and cause significant morbidity. International HIV Dementia Scale (IHDS) is a quite sensitive and specific method for screening for HAND, and Modified Mini-Mental State Examination (3MS), though nonspecific, contains more parameters for screening for neurocognition. Hence, we compared 3MS and IHDS as screening tools for HAND with an aim to find out which was a better screening tool for HAND. Methods: Using 3MS and IHDS, we assessed the cognitive status of 200 HIV-positive patients (65% males) and 84 controls, presenting to the Department of Medicine, King George’s Medical University, Lucknow, India from September 2015 to September 2019. Results: According to 3MS, 42 (21%) HIV-positive patients were neurocognitively impaired (mean 76.24 ± 1.51), and 158 (79%) patients were not (mean 87.02 ± 4.16). As per IHDS, 185 (92.5%) HIV patients were neurocognitively impaired (mean 8.45 ± 0.88), and 15 (7.5%) patients were not (mean 11.13 ± 0.35). The mean 3MS score of controls was 87.56 ± 4.26, and the IHDS score was 9.73 ± 1.00. According to Patient Health Questionnaire-9 (PHQ-9), moderate depression occurred in only 3.5% of the patients, and the rest had only minimal or mild depression. In IHDS, psychomotor speed was the most affected parameter, whereas in 3MS, similarities were the most affected. Conclusion: IHDS may be over diagnosing neurocognitive impairment in HIV patients due to difficulty in understanding the test, especially psychomotor speed testing. 3MS may be more accurate for detecting neurocognitive impairment in HIV patients, and scale combining both these methods may be a still better choice.

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“…Bivariate and multivariate generalized linear modelling (GLM) were used to calculate the crude and adjusted MDs and the corresponding 95% confidence intervals (CIs) comparing the level of depressive symptoms across levels of HIV disclosure. Because persons newly diagnosed with HIV have been shown to have elevated risks of depression [35] and because they may not have enough time to disclose their HIV status, all analyses were a priori stratified by whether HIV was diagnosed prior to or during the current pregnancy.…”

Section: Statistical Analysesmentioning

confidence: 99%

HIV disclosure and depressive symptoms among pregnant women living with HIV: a cross‐sectional study in the Democratic Republic of Congo

et al. 2022

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Introduction: Disclosure of one's HIV status may decrease depression and improve the quality of life among people living with HIV. However, there is mixed evidence on the impact of disclosure to partners for pregnant women living with HIV (WLHIV) in areas of intersecting social concerns over disclosure and high prevalence of intimate partner violence (IPV). We assessed the association between HIV disclosure and depressive symptoms among pregnant WLHIV in the Democratic Republic of Congo (DRC) and examined whether the knowledge of partner's status or recent IPV modified this association. Methods: We utilized data from participants enrolled in a trial to evaluate the effect of continuous quality interventions on long-term therapy outcomes among HIV-positive pregnant and breastfeeding women in DRC (NCT03048669). Only pregnant women (n = 1392) were included in this cross-sectional analysis. Between November 2016 and June 2019, enrolled participants completed a survey that included the Patient Health Questionnaire-9 (PHQ-9) to screen recent depressive symptoms, questions about disclosure, knowledge of partner's status and IPV. We used linear models to calculate crude and adjusted mean differences (MDs) between disclosure and depressive symptoms. All analyses were stratified by timing of HIV diagnosis. Results: Disclosure was higher among participants diagnosed prior to current pregnancy (41% to their partners and 24% to family, friends or others) relative to those diagnosed during current pregnancy (21% to partners and 12% to family). About one-quarter of women reported any type of IPV in the past 12 months. Disclosure to a partner was associated with lower depressive symptoms among women diagnosed prior to current pregnancy (MD −0.55; 95% CI: −1.06, −0.04) but the opposite was observed among those diagnosed during current pregnancy (MD 0.5; 95% CI: −0.4, 1.4). Adjustment for IPV, knowledge of partner's status, age, number of living children and primigravidae did not change MDs substantially. Conclusions: Women in our sample mostly disclosed to partners despite high IPV burden. The observed association between disclosure to partners and lower depressive symptoms among women diagnosed prior to current pregnancy is consistent with cross-national evidence. A prospective study among pregnant WLHIV is needed to examine longitudinal effects of HIV status disclosure.

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Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

Cited by 11 publications

References 54 publications

Facing the quality of life: physical illness, anxiety, and depression symptoms among people living with HIV in rural Zambia – a cross-sectional study

Facing the quality of life: physical illness, anxiety, and depression symptoms among people living with HIV in rural Zambia – a cross-sectional study

Is International HIV Dementia Scale good enough to diagnose HIV-associated neurocognitive disorders?

HIV disclosure and depressive symptoms among pregnant women living with HIV: a cross‐sectional study in the Democratic Republic of Congo

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