Abstract
Health-related quality of life is lower in people living with HIV compared to the general population, particularly because of higher levels of depression. Little is known about the differences between HIV-infected ethnic Danes and HIV-infected non-ethnic Danes at risk of depression. This study aimed to explore coping styles and social relations among HIV-infected ethnic Danes and non-ethnic Danes in two outpatient clinics. HIV-infected individuals from two out-patients clinics were included in a questionnaire-based study. The Beck Depression Inventory II (BDI-II) was used to assess the prevalence and severity of depressive symptoms. Coping was measured using the Coping Self-Efficacy scale (CSE) and social relations factors were marital status, loneliness, disclosure of HIV status and satisfaction with support from family and friends. Among 442 HIV-infected individuals, 21% were in risk of depression assessed by The Beck Depression Inventory II (BDI-II ≥ 20) and higher among non-ethnic Danes. The difference in mean Coping self-efficacy (CSE) between those at risk of depression and those not at risk was -78.95 95%CI (-89.10; -68.81). Non-ethnic Danes had higher scores on two CSE subscales, compared with ethnic Danish HIV-infected individuals. No ethnic difference was found in the subscale social support. Reduced logistic regression model showed that loneliness, satisfaction with support from family and friends and marital status was associated with risk of depression. Improvement of CSE and social relations seems to be important to resilience to depression among HIV-infected individuals. Lack of social support might be a barrier for HIV-infected achieving resilience to depression, despite ethnicity.
Highlights
Today, human immunodeficiency virus (HIV) is no longer a fatal disease due to effective treatment [1]
This study investigates the difference in level of coping self-efficacy, and social relation factors in HIV-infected individuals at risk of depression compared to HIV-infected individuals not at risk of depression
The findings are in agreement with our previous study of Coping self-efficacy (CSE) and depression [10] and is supported by Gore-Felton et al and Simoni & Ng who found that a higher use of maladaptive or avoidance coping is related to depression [27, 28]
Summary
Human immunodeficiency virus (HIV) is no longer a fatal disease due to effective treatment [1]. Despite advances in HIV treatment, living with HIV today is as much a psychological and social phenomenon as a physiological and medical concern. The association between depression and HIV is complex and bi-directional, with several components that may lead to depression. These components can be divided into two categories; 1) components caused by the disease such as neurobiological changes and side effects of antiviral therapy, and 2) psychosocial components such as coping strategies and social relations [3, 7]
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