Abstract
BackgroundThe presence of depression in people living with HIV/AIDS could lead to non-adherence to antiretroviral medications. It also leads to further comorbid and opportunistic illness and then lowering the patient's quality of life. The objective of this study was therefore to determine the pooled prevalence of depression and its related factors in HIV patients.MethodsRelevant articles in PubMed, Scopus, and EMBASE were investigated. The Meta-XL version 5.3 was used to extract data and STATA-11 Meta-prop packages with the Random effect model was used to quantify depression and its related factors. Sensitivity and subgroup analysis were performed to explore sources of heterogeneity. The Cochran’s Q-statistic and the Higgs I2 test were also done. Besides, the Eggers test and symmetry in the funnel plot were used to detect the presence/absence of publication bias.ResultIn this meta-analysis, we included 21 articles that assessed 10,090 participants. The average prevalence of depression among people with HIV/AIDS was 35.8% (95% CI 28.29, 43.25). The average estimated prevalence of depressive symptoms was 59.4% in the Oromia region and 29.25% in southern Ethiopia. Besides, the average prevalence of depression was 45.6% and 26.2% as measured with Beck’s depression inventory and Hospital anxiety and depression scale respectively. Moreover, the prevalence of depression was 47.7% in studies that used a sample size ≤ of 400 participants and 28.5% in studies that used a sample size of > 400 participants. The pooled adjusted odds ratio (AOR) of perceived HIV stigma was 3.75 (95% CI 2.34, 5.16) and that of poor social support was 6.22 (95% CI 2.96, 9.47). Moreover, the average odds ratio of poor medication adherence, opportunistic infection, and advanced stages of AIDS were 3.03 (95% CI 1.00, 5.05), 5.5 (95% CI 1.97, 10.03), and 5.43 (95% CI 1.60, 9.28) respectively.ConclusionThe pooled prevalence of depression among individuals living with HIV/AIDS was high. Factors such as perceived HIV stigma, poor social support, opportunistic infection, advanced AIDS stage, and poor medication adherence were related to it. Routine screening and management of depression and its related factors should be given due consideration.
Highlights
The presence of depression in people living with Human Immune Virus (HIV)/Acquired Immune-deficiency Syndrome (AIDS) could lead to non-adherence to antiretroviral medications
The pooled prevalence of depression among individuals living with HIV/AIDS was high
Another systematic review study done in sub-Saharan Africa on depression among HIV patients incorporated 30 studies and a total of 10,000 participants from 10 countries
Summary
The presence of depression in people living with HIV/AIDS could lead to non-adherence to antiretroviral medications. More than 350 million people are living with depression [1] It is the fourth leading cause of disability and is the second leading cause of disability with its lifetime prevalence in the general population estimated to be approximately 3 to 17% [2]. A systematic review and meta-analysis study by Uthman 2014 [4] found that the prevalence of depression in HIV-positive people in low-, middle-, and high-income countries range from 12.8% to 78%. Another systematic review study done in sub-Saharan Africa on depression among HIV patients incorporated 30 studies and a total of 10,000 participants from 10 countries. A study in sub-Saharan Africa reported the prevalence of depression range from 9 to 32% [6]. Other individual studies from different countries reported that depression in HIV positive individuals was 28.1% in France [8], 40% in India [9], 37.6% in South Africa [10], 47% in Uganda [11], 56.7% in Nigeria [12], 28% in Kenya, Tanzania and Namibia together [13]
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