Abstract
Introduction: HIV has much comorbidity that includes depression. Additionally, disability has been found to manifest in HIV. However, the intersection between these co-morbidities is unknown. The primary aim is investigating the link between the onset of disability and depressive symptoms amongst a cohort of patients on antiretroviral treatment. Materials and method: We conducted a cross sectional survey in an urban area of South Africa including measures for depressive symptoms, functional limitations/disability, adherence, HIV-related health symptoms, and livelihood. One thousand and fifty-five adult individuals (≥ 18 years old) were recruited from Themba Lethu HIV clinic in Johannesburg between August 2014–May 2015. Bivariate and logistic regression analysis was used to determine associations. Results: Participants experiencing depressive symptoms had higher functional limitations on all sub-categories expect for one. The logistic regression model revealed that having depressive symptoms as a bivariate dependent variable and age, physical health, and disability as independent variables were statistically significantly associated, χ² (3)=199.63, p<0.001. The model explained 23.7% (Nagelkerke R²) of the variance in depressive symptom classification, with increases in age, physical health symptoms, and disability being associated with an increase in symptoms. Conclusion: As reported in a related study functional limitations, age, and health symptoms were directly associated to an increase in depressive symptoms. Gender and ART adherence were not found to be significant contributing variables to depressive symptoms when controlling for other covariates (disability, age, physical health). Hence, the association between depressive symptoms, health, and disability is much more nuanced and complex than previously anticipated. Development of a comprehensive continuum of care needs to consider the importance of disability as both a driver of depression and an outcome. Rehabilitation interventions hold a key to addressing these new health-related needs now that people survive the acute stages of AIDS and can live a long life.
Highlights
HIV has much comorbidity that includes depression
A growing body of evidence suggests that depression, depressive symptoms, functional limitations, and disability are linked to living with chronic HIV
While this research study only used a cohort of people on long term antiretroviral therapy (ART), the measured experience of functional limitations is with around 50% of the sample much higher than the prevalence of disability measured with the last South African census (7.5%, 2011)
Summary
HIV has much comorbidity that includes depression. disability has been found to manifest in HIV. A national and government-sponsored ART-programme in South Africa has resulted in increased survival rates among people living with HIV (PLHIV) and decreased morbidity [2,3]. This transition comes with new health-related needs linked to the chronicity of the disease that for many will span several decades of life [4,5,6,7,8]. An early study [9] showed that 81% of patients who were 95% adherent to their medication regimen demonstrated viral suppression. One of the factors associated to ART adherence is comorbid depression [12]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
