# Depression and Its Predictors in Adults Receiving Antiretroviral Therapy

## TL;DR

This study finds that over half of HIV-positive adults on antiretroviral therapy experience depression, with factors like being unmarried, female, and having low social support increasing the risk.

## Contribution

The study identifies key predictors of depression in HIV-positive adults receiving antiretroviral therapy in Nigeria.

## Key findings

- Depression prevalence among HIV-positive adults on ART was 54%.
- Being unmarried, female, and having low social support were significant predictors of depression.
- Unemployment was also associated with a lower likelihood of depression.

## Abstract

Background and aim

Depression is a common psychiatric morbidity seen in adults living with HIV/AIDS. Several contextual factors have been implicated in the pathogenesis of depression in HIV-positive adults, these factors could be clinical, treatment-related, or socio-demographic in nature. Due to the debilitating nature of depression and its adverse effect on antiretroviral treatment adherence, HIV-positive adults living with depression are at risk of sub-optimal treatment response and, consequently, poor health outcomes. This suggests that there is a need for more research on depression and its risk factors in HIV-positive adults, as this could inform the promotion of preventive measures against the disorder, as well as early identification and treatment of affected persons. This study aimed to determine the prevalence and predictors of depression among HIV-positive adults receiving antiretroviral therapy.

Methods

This was a cross-sectional study of 257 HIV-positive adults conducted at the Hematology Clinic of the Lagos State University Teaching Hospital, Ikeja, Nigeria. Respondents were selected using a systematic random sampling method. Study instruments used were as follows: the Patient Health Questionnaire (PHQ-9), the four-item Morisky Medication Adherence Scale (MMAS-4), the Multidimensional Perceived Social Support Scale (MPSSS), and a socio-demographic/clinical data questionnaire. Data were analyzed using the EPI-Info statistical analysis software version 7.0 (Atlanta, GA: Centers for Disease Control and Prevention). Univariate, bivariate, and multivariate analyses were done to determine the prevalence and predictors of depression among HIV-positive adults.

Results

The prevalence of depression was 54%, and predictors of depression were being unmarried (n=91, OR=10.9, 95% CI=4.6-26.2, p=0.000), female gender (n=119, OR=5.8, 95% CI=2.2-15.5, p=0.000), low social support (n=57, OR=11.2, 95% CI=4.1-30.8, p=0.000), and unemployment (n=27, OR=0.2, 95% CI=0.1-0.7, p=0.007).

Conclusion

Depression is frequently reported among HIV-positive adults, and its occurrence may be influenced by clinical, social, and demographic-related factors. These variables need to be considered in patient care at antiretroviral clinics in order to achieve a good treatment prognosis. Furthermore, future research may focus on intervention studies on depression in HIV-positive adults, especially in those with increased vulnerability to depression.