title: Depression and CD4 cell count among persons with HIV infection in Uganda.
abstract: Despite the importance of mental illness and the high prevalence of HIV in Africa, few studies have documented depressive symptoms among HIV-infected persons in Africa. We assessed factors associated with depression among HIV-infected adults undergoing anti-retroviral eligibility screening in Eastern Uganda. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Univariate and multiple regression analyses were conducted to identify socio-demographic characteristics and disease-related factors associated with depression. Among 1017 HIV-infected participants assessed for depression, 47% (476/1017) reported depressive symptoms (CES-D >/= 23). Adjusting for age, gender, education, and source of income, patients with CD4 counts <50 cells/microl were more likely to be depressed (odds ratio 2.34, 95% confidence interval, 1.39-3.93, P = 0.001). Women, participants >50 years, and those without an income source were more likely to be depressed. Depression was common among HIV-infected persons in rural Uganda and was associated with low CD4 cell counts. Appropriate screening and treatment for depression should be considered for comprehensive HIV care.
authors.affiliation: Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Kaharuza
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bunnell
authors.forename: Susan
authors.initials: S
authors.lastname: Moss
authors.forename: David W
authors.initials: DW
authors.lastname: Purcell
authors.forename: Winnie
authors.initials: W
authors.lastname: Bikaako-Kajura
authors.forename: Nafuna
authors.initials: N
authors.lastname: Wamai
authors.forename: Robert
authors.initials: R
authors.lastname: Downing
authors.forename: Peter
authors.initials: P
authors.lastname: Solberg
authors.forename: Alex
authors.initials: A
authors.lastname: Coutinho
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mermin
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012720:Severity of Illness Index; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents