title: Prevalence and correlates of depression among HIV-infected and -affected older people in rural South Africa.
abstract: BACKGROUND
  Little is known about depression in older people in sub-Saharan Africa, the associated impact of HIV, and the influence on health perceptions.
  
  
  OBJECTIVE
  Examine the prevalence and correlates of depression; explore the relationship between depression and health perceptions in HIV-infected and -affected older people.
  
  
  METHODS
  In 2010, 422 HIV-infected and -affected participants aged 50+ were recruited into a cross-sectional study. Nurse professionals interviewed participants and a diagnosis of depressive episode was derived from the Composite International Diagnostic Interview (Depression module) using the International Classification of Diseases diagnostic criteria and categorised as major (MDE) or brief (BDE).
  
  
  RESULTS
  Overall, 42.4% (n=179) had a depressive episode (MDE: 22.7%, n=96; BDE: 19.7%, n=83). Prevalence of MDE was significantly higher in HIV-affected (30.1%, 95% CI 24.0-36.2%) than HIV-infected (14.8%, 95% CI 9.9-19.7%) participants; BDE was higher in HIV-infected (24.6%, 95% CI 18.7-30.6%) than in HIV-affected (15.1%, 95% CI 10.3-19.8%) participants. Being female (aOR 3.04, 95% CI 1.73-5.36), receiving a government grant (aOR 0.34, 95% CI 0.15-0.75), urban residency (aOR 1.86, 95% CI 1.16-2.96) and adult care-giving (aOR 2.37, 95% CI 1.37-4.12) were significantly associated with any depressive episode. Participants with a depressive episode were 2-3 times more likely to report poor health perceptions.
  
  
  CONCLUSIONS
  Study limitations include the cross-sectional design, limited sample size and possible selection biases.
  
  
  CONCLUSIONS
  Prevalence of depressive episodes was high. Major depressive episodes were higher in HIV-affected than HIV-infected participants. Psycho-social support similar to that of HIV treatment programmes around HIV-affected older people may be useful in reducing their vulnerability to depression.
authors.affiliation: Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa. mnyirenda@africacentre.ac.za
authors.forename: M
authors.initials: M
authors.lastname: Nyirenda
authors.forename: S
authors.initials: S
authors.lastname: Chatterji
authors.forename: T
authors.initials: T
authors.lastname: Rochat
authors.forename: P
authors.initials: P
authors.lastname: Mutevedzi
authors.forename: M-L
authors.initials: ML
authors.lastname: Newell
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology
keywords: Brief depressive episode; Depression; HIV-infected; Major depressive episode; Older people; South Africa