Determinants of Depressive Symptoms in People Living with HIV: Findings from a Population-Based Study with a Gender Perspective

Abstract

Depressive symptoms are common among people living with HIV (PLWH). The aim of this study was to identify the determinants of depressive symptoms in PLWH in Spain. A total of 1060 PLWH participated in this cross-sectional study and completed the Patient Health Questionnaire-9. The odds ratios for the presence of depressive symptoms were analyzed in a multivariable logistic regression model, including sociodemographic data, comorbidities, health-related behaviors, and social-environment-related variables. We found an overall prevalence of depressive symptoms of 21.42%; by subgroup, namely men, women, and transgender persons, prevalence was 18.13%, 32.81%, and 37.14%, respectively. Moreover, social isolation (OR = 1.05 [CI, 1.02–1.08]) and poor physical and mental quality of life (OR = 1.06 [CI, 1.02–1.09] and OR = 1.13 [CI, 1.09–1.17], respectively) were associated with depressive symptoms. As protective factors, we identified serodisclosure to more people (vs. none; OR = 0.39 [CI, 0.17–0.87]), satisfaction with social roles (OR = 0.86 [CI, 0.79–0.94]), better cognitive function (OR = 0.92 [CI, 0.89–0.95]), and sexualized drug use once in a lifetime (OR = 0.52 [CI, 0.29–0.93]). This study showed a high prevalence of depressive symptoms in PLWH, especially among women and transgender people. The association between psychosocial variables and depressive symptoms highlights the multidimensionality of the problem and identifies areas for intervention. This study found that the management of mental health issues is an area that needs to be improved and tailored to specific groups, with the aim of enhancing the well-being of PLWH.

Syndemic conditions and quality of life in the PISCIS Cohort of people living with HIV in Catalonia and the Balearic Islands: a cross sectional study

“…Although depressive symptoms were the syndemic factor with a stronger association with a worse HRQoL, most syndemic conditions were associated with an impairment in HRQoL in both domains (PH and MH), even after adjustment for several confounding variables. A range of factors could be related to high prevalence of depressive symptoms among PLWH, including those related to living with a chronic disease [ 14 , 60 ], low income or living in poverty [ 4 , 22 ], stigma and discrimination [ 26 ], feelings of loneliness [ 30 , 61 ] or fear of disclosure [ 61 , 62 ]. Whatever the drivers of depression, early identification and treatment are of great importance, as depression has been associated with poor adherence to antiretroviral therapy (ART) [ 63 – 65 ].…”

Predictors of poor health‐related quality of life among people living with HIV aged ≥60 years in the PISCIS cohort: Findings from the Vive+ project

“…We ran the model from 1 to 10 latent classes and eventually chose the optimal number after considering the following indicators: the lowest value of the adjusted Bayesian information criterion, the consistent Akaike information criterion, the entropy index (values close to 0.80), interpretability, and clinical criteria. Further details on the methodology and results of this latent class analysis can be found in Bayes‐Marin et al [17]. Cluster 1 mainly contained patients who did not consume drugs or mostly consumed common drugs (cannabis, cocaine, Viagra or poppers), with a 4% polyconsumption of two drugs at most.…”

“…We used multiple imputation algorithms to deal with missing data for all potential confounding and exposure variables among all participants. In total, 20 imputed datasets were generated and can be consulted at Bayes‐Marin et al [17]. We performed a descriptive analysis of all patients aged <60 and ≥60 years.…”

“…The study of HRQoL is especially relevant in older people living with HIV, as older age has been associated with lower HRQoL in different studies [14][15][16], including in our setting [17]. The synergic effects of ageing and HIV result in premature senescence and immune decline, potentially accelerating the ageing process [18] but this remains a subject of debate [19].…”

Multimodal Approach to Neurocognitive Function in People Living with HIV in the cART Era: A Comprehensive Review

“…Depression has been linked with several adversities in the everyday life of PLWH, resulting in a worse quality of life and increased morbidity and mortality [36,37]. Depression is also associated with nonadherence to cART, higher rates of detectable viral load, and decreased functionality that might lead to reduced professional productivity and social isolation [38]. Furthermore, depression and anxiety have both been associated with the presence of HIV-associated NCI [39][40][41].…”