Abstract
BackgroundHIV/AIDS and depression are projected to be the two leading causes of disability by 2030. HIV/AIDS and anxiety/depression are interlinked. People suffering from depression may be more likely to engage in risky sexual behaviour, and therefore at greater risk of contracting HIV. An HIV + diagnosis may trigger symptoms of anxiety and depression, which may in turn result in risky sexual behaviour and the spread of HIV. This study explores correlates of anxiety and depression in patients enrolled in a public sector ART programme in South Africa.MethodsInterviews were conducted with 716 patients initiating ART at twelve public health care facilities in the Free State. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). An 8+ cut-off was used to identify possible cases of anxiety and depression. Multivariate logistic regression analysis, using STATA Version 11, was performed to identify correlates of anxiety and depression.ResultsThe prevalence of symptoms of respectively anxiety and depression amongst this study population in the Free State was 30.6% and 25.4%. The multivariate logistic regression analyses identified five correlates of symptoms of anxiety and depression. Disruptive side effects (OR = 3.62, CI 1.95-6.74) and avoidant coping (OR = 1.42, CI 1.22-1.65) were associated with a greater number of symptoms of anxiety. Stigma was associated with an increase in symptoms of anxiety (OR = 1.14, CI 1.07-1.21) and of depression (OR = 1.13, CI 1.06-1.20), while being a widow (OR = 0.30, CI 0.13-0.69) and participating in a support group (OR = 0.21, CI 0.05-0.99) were associated with decreased symptoms of depression.ConclusionsThe findings from the study provide valuable insights into the psychosocial aspects of the Free State public-sector ART programme. Combined with the literature on the intricate link between mental health problems and treatment outcomes our results emphasise firstly, the necessity that resources be allocated for both screening and treating mental health problems and, secondly, the need for interventions that will encourage support-group participation, address ART side effects, reduce maladaptive coping styles, and minimise the stigma associated with symptoms of anxiety and/or depression.
Highlights
HIV/AIDS and depression are projected to be the two leading causes of disability by 2030
Studies have shown that people suffering from depression are less likely to adhere to treatment - treatment for both mental illness and for antiretroviral treatment (ART) [9]
Data This study is part of a cohort study entitled “Effective Aids Treatment and Support in the Free State (FEATS)” that was conducted by the Centre for Health Systems Research and Development (CHSR&D) of the University of the Free State (UFS)
Summary
HIV/AIDS and depression are projected to be the two leading causes of disability by 2030. An HIV + diagnosis may trigger symptoms of anxiety and depression, which may in turn result in risky sexual behaviour and the spread of HIV. People suffering from depression may be more likely to engage in risky sexual behaviour, and they are at greater risk of contracting HIV [4,5,6]. An HIV + diagnosis may trigger symptoms of anxiety and depression [7,8], which could once again lead to risky sexual behaviour and the spreading of the virus. More than half of the HIV + population that suffer from depression have not received an official diagnosis of their depression [10]
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