Declining prevalence of probable depression among patients presenting for antiretroviral therapy in rural Uganda: the role of early treatment initiation.
Little is known about trends in depression at antiretroviral therapy (ART) initiation among people living with HIV (PLHIV) in low- and middle-income countries. We used data from an ongoing cohort of treatment-naïve PLHIV in rural Uganda to estimate secular trends in depression among PLHIV at ART initiation. We fitted linear regression models with depression symptom severity as the outcome variable and year of cohort entry (2005-2012) as the explanatory variable, adjusting for socio-demographic variables and assessing physical health score, body mass index (BMI), and CD4 count as potential mediators of a secular trend in depression symptom severity. There was a statistically significant negative association between year of entry and depression symptom severity, suggesting a 3.1 % relative decline in the mean depression symptom severity score at ART initiation in each year of study recruitment after the first year. This trend remained statistically significant after inclusion of baseline socio-demographic characteristics to the model and appeared to be driven by improved physical health scores, but not CD4 count or BMI.
Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street GRJ 504, 02114-2696, Boston, MA, USA, bchan@partners.org.
Brian T
BT
Chan
Sheri D
SD
Weiser
Yap
Y
Boum
Jessica E
JE
Haberer
Annet
A
Kembabazi
Peter W
PW
Hunt
Jeffrey N
JN
Martin
A Rain
AR
Mocello
David R
DR
Bangsberg
Alexander C
AC
Tsai
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D015995:Prevalence; D011336:Probability; D012424:Rural Population / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D057545:Social Stigma; D014342:Truth Disclosure; D014454:Uganda / Q000453:epidemiology; D016903:Drug Monitoring
D019380:Anti-HIV Agents