Abstract
BackgroundNot much is known about the risk factors of major depressive disorder (MDD) in HIV/AIDS in the African socio-cultural context. Therefore a study was undertaken to examine the prevalence and risk factors of MDD in HIV/AIDS in semi-urban Uganda.MethodsA cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda.ResultsPrevalence of MDD was 8.1%. Factors associated with MDD at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress; not associated with MDD were social support, neurocognitive impairment, CD4 counts and BMI. Factors independently associated with MDD were psychosocial impairment, adverse life events, post traumatic stress disorder, generalised anxiety disorder and life-time attempted suicide.ConclusionPsychological and social factors were the main risk factors of MDD among ambulatory HIV positive persons with no evidence for the role of the neurotoxic effects of HIV. Treatment approaches for MDD in this patient group should be modeled on those used among non-HIV groups.
Highlights
Not much is known about the risk factors of major depressive disorder (MDD) in HIV/AIDS in the African socio-cultural context
The increasing access to highly effective antiretroviral therapy (ART) for people living with HIV (PLWHA) even in low income countries including in sub-Saharan Africa has delayed HIV disease progression and prolonged survival bringing into sharp focus issues of quality of life including their mental wellbeing [1,2]
Negative Psychological & social factors - negative coping style - past psychiatric history –comorbid psychiatric disorders -poor social support up for their interview appointment even after being repeatedly contacted by telephone. Those who refused to participate in this study did not differ significantly from those who were enrolled into the study on gender and age
Summary
Not much is known about the risk factors of major depressive disorder (MDD) in HIV/AIDS in the African socio-cultural context. One of the major causes of psychiatric morbidity in HIV/AIDS is major depressive disorder (MDD), with studies from Africa reporting point prevalence rates of MDD of between 3% to 54% [3,4,5,6,7,8] Most of these studies were small, used nonlocally validated screening scales to diagnose MDD and rarely examined risk factors. Studies in the west have pointed to a multifactorial aetiology of MDD in HIV/AIDS including psychological, This paper examines the prevalence and risk factors of MDD in HIV/AIDS as seen in the African socio-cultural context of Uganda with a view to inform the development of mental health interventions for PLWHA on the African sub-continent
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