The Association between Aids Related Stigma and Major Depressive Disorder among HIV-Positive Individuals in Uganda

Dickens Akena,Dan J Stein,Seggane Musisi,John Joska,D William Cameron

doi:10.1371/journal.pone.0048671

Dickens Akena, Dan J Stein + Show 3 more

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https://doi.org/10.1371/journal.pone.0048671

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Journal: PloS one	Publication Date: Nov 27, 2012
Citations: 95	License type: CC BY 4.0

Affiliation: University of Cape Town, Makerere University

Abstract

BackgroundMajor depressive disorder in people living with HIV/AIDS (PLWHA) is common and may be associated with a number of factors, including AIDS-related stigma, decreased CD4 levels, increased opportunistic infections and sociodemographic variables. The extent to which AIDS-related stigma is associated with major depressive disorder among PLWHA has not been well studied in sub-Saharan Africa. The objective of this study was to examine the associations between major depressive disorder, AIDS-related stigma, immune status, and sociodemographic variables with the aim of making recommendations that can guide clinicians.MethodsWe assessed 368 PLWHA for major depressive disorder, as well as for potentially associated factors, including AIDS-related stigma, CD4 levels, presence of opportunistic infections, and sociodemographic variables.ResultsThe prevalence of major depressive disorder was 17.4%, while 7.9% of the participants had AIDS related stigma. At multivariable analysis, major depressive disorder was significantly associated with AIDS-related stigma [OR = 1.65, CI (1.20–2.26)], a CD4 count of ≥200 [OR 0.52 CI (0.27–0.99)], and being of younger age [0.95, CI (0.92–0.98).ConclusionsDue to the high burden of major depressive disorder, and its association with AIDS related stigma, routine screening of PLWHA for both conditions is recommended. However, more research is required to understand this association.

Highlights

HIV/AIDS is one of the biggest health crises the world faces today, with close to two-thirds of all people living with HIV/AIDS (PLWHA) residing in sub-Saharan Africa [1]
Other researchers have documented that PLWHA suffering from depression progress faster from HIV to AIDS compared to non-depressed PLWHA [14,15,16,17]
Previous studies conducted among PLWHA in Uganda have reported higher depression prevalence [9,45]; findings which could be explained by the fact that in those studies, the diagnosis of depression was

Summary

Introduction

HIV/AIDS is one of the biggest health crises the world faces today, with close to two-thirds of all people living with HIV/AIDS (PLWHA) residing in sub-Saharan Africa [1]. The prevalence of depressive disorder among PLWHA in Uganda has been reported as 20–40% [7,8,9,10]. Depressive disorder in PLWHA has been associated with several critical adverse health- related outcomes. Major depressive disorder in people living with HIV/AIDS (PLWHA) is common and may be associated with a number of factors, including AIDS-related stigma, decreased CD4 levels, increased opportunistic infections and sociodemographic variables. The extent to which AIDS-related stigma is associated with major depressive disorder among PLWHA has not been well studied in sub-Saharan Africa. The objective of this study was to examine the associations between major depressive disorder, AIDS-related stigma, immune status, and sociodemographic variables with the aim of making recommendations that can guide clinicians

Objectives

Methods

Results

Conclusion