Prevalence of depression and associated factors among HIV/AIDS patients in India: a systematic review and meta-analysis

Abstract

Depression represents a significant comorbidity in people living with HIV and AIDS (PLWHA). The purpose of this study was to assess the prevalence of depression among PLWHA in India and to identify the factors associated with it. Following PRISMA guidelines, a thorough search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify relevant records. The overall prevalence was determined using a random-effects model, at 95% confidence interval. Eighteen studies, encompassing a total sample of 5082 PLWHA, were examined. The pooled prevalence of depression among PLWHA in India was 39.1% (95% CI: 30.4; 48.5). Subgroup analysis demonstrated prevalence rates of 56.0% in the East, 47.7% in Central India, 45.5% in the North, 37.6% in the West, and 26.9% in the South regions of India (p < 0.01). Another subgroup analysis based on the assessment tool used revealed significantly varying prevalence rates of depression (p < 0.01): 56.5% in studies employing CES-D (Center for Epidemiologic Studies - Depression) scale, 48.5% with MADRS (Montgomery-Asberg Depression Rating Scale), and 18.1% using PHQ-9 (Patient Health Questionnaire-9). Female gender, lack of education and employment, low self-esteem, and experiencing negative stigma were identified as factors associated with depression among PLWHA. Depression is prevalent among PLWHA in India, highlighting the importance of regular screening and management of mental health conditions in this population.