title: Psychosocial functioning and depressive symptoms among HIV-positive persons receiving care and treatment in Kenya, Namibia, and Tanzania.
abstract: In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIV attending HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Eighteen HIV care and treatment clinics (six per country) enrolled approximately 200 HIV-positive patients (for a total of 3,538 participants) and collected data on patients' physical and mental well-being, medical/health status, and psychosocial functioning. Although the majority of participants did not report clinically significant depressive symptoms (72 %), 28 % reported mild to severe depressive symptoms, with 12 % reporting severe depressive symptoms. Regression models indicated that greater levels of depressive symptoms were associated with: (1) being female, (2) younger age, (3) not being completely adherent to HIV medications, (4) likely dependence on alcohol, (5) disclosure to three or more people (versus one person), (6) experiences of recent violence, (7) less social support, and (8) poorer physical functioning. Participants from Kenya and Namibia reported greater depressive symptoms than those from Tanzania. Approximately 28 % of PLHIV reported clinically significant depressive symptoms. The scale-up of care and treatment services in sub-Saharan Africa provides an opportunity to address psychosocial and mental health needs for PLHIV as part of comprehensive care.
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, MS E04, Atlanta, GA, 30333, USA, pseth@cdc.gov.
authors.forename: Puja
authors.initials: P
authors.lastname: Seth
authors.forename: Daniel
authors.initials: D
authors.lastname: Kidder
authors.forename: Sherri
authors.initials: S
authors.lastname: Pals
authors.forename: Julie
authors.initials: J
authors.lastname: Parent
authors.forename: Redempta
authors.initials: R
authors.lastname: Mbatia
authors.forename: Kipruto
authors.initials: K
authors.lastname: Chesang
authors.forename: Deogratius
authors.initials: D
authors.lastname: Mbilinyi
authors.forename: Emily
authors.initials: E
authors.lastname: Koech
authors.forename: Mathias
authors.initials: M
authors.lastname: Nkingwa
authors.forename: Frieda
authors.initials: F
authors.lastname: Katuta
authors.forename: Anne
authors.initials: A
authors.lastname: Ng'ang'a
authors.forename: Pamela
authors.initials: P
authors.lastname: Bachanas
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006305:Health Status Indicators; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D009276:Namibia / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data