Depressive Symptoms and Associated Factors Among People Living with HIV/AIDS and Undergoing Antiretroviral Therapy: A Cross-Sectional Study in the Amathole District, South Africa

Background and Aim: People living with HIV/AIDS (PLWHA) are susceptible to depressive symptoms. Consequently, we examined the prevalence of depressive symptoms and associated factors among PLWHA and on antiretroviral therapy (ART) in South Africa. Methods: We conducted a cross-sectional study of 150 PLWHA on ART in primary health facilities in Amathole District, Eastern Cape Province of South Africa. A self-designed questionnaire solicits information on participant's demographic characteristics. Patient Health Questionnaire (PHQ-9) rating scale was used to screen depressive symptoms (cut-off point of <= 5). Data was also collected on lifestyle behaviours, early ART initiation, medication adherence, depression-related symptoms, and depression severity scores. Results: The prevalence of depressive symptoms was 41.3%, with females exhibited higher prevalence (67.7%) compared to males (32.3%). Depressive symptoms was significantly associated with unemployment, female gender, low educational level, and HIV staging. Predictors of depressive symptoms were lower CD4 cell count of 350 to 500 (OR=4.0; 1.05-17.50), pain and discomfort (OR=6.2; 1.69-28.01), suffering from complications and opportunistic diseases (OR=1.5; 0.19-3.49), experiencing discrimination at health facilities (OR=11.0; 0.93-167.1), and workplaces (OR=18.1; 2.53-43.23), and being satisfied with ART treatment results (OR=0.1; 0.05-1.06).Conclusion: Depressive symptoms was high among PLWHA in this setting, and particularly in women compared to men. Low CD4 cell count, pain and discomfort, complications and opportunistic diseases, discrimination at health facilities and workplaces were more likely susceptible to depressive symptoms. Mental health screening should be prioritised in primary health care facilities for early detection of depressive symptoms to facilitate prompt referrals and treatment.

Automated summary

The prevalence of depressive symptoms is high among people living with HIV/AIDS (PLWHA), especially among females. Factors such as lower CD4 cell count, pain and discomfort, complications and opportunistic diseases, discrimination at health facilities and workplaces, and satisfaction with ART treatment results are associated with higher susceptibility to depressive symptoms. Mental health screening in primary health care facilities is important for early detection of depressive symptoms and prompt referrals and treatment.