Depressive Symptoms, Gender, Disclosure, and HIV Care Stage Among People Living with HIV in Cameroon

Prevalence of Depression Among People Living with HIV on Antiretroviral Therapy in Africa: A Systematic Review and Meta-Analysis

BACKGROUND

HIV is a global health issue, with the highest number of infected individuals found in sub-Saharan Africa. The coexistence of HIV with depression is a huge challenge. This study aimed to investigate the prevalence of depression in people living with HIV (PLWHIV) who are on antiretroviral therapy (ART) in Africa.

METHOD

PubMed, Scopus, and bibliographic screening were used to identify suitable literature. The study adhered to guidelines outlined by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Newcastle-Ottawa guideline was used to assess the quality of the included cross-sectional studies. Subgroup analysis and meta-regression were subsequently conducted following the meta-analyses, based on heterogeneity. A meta-analysis software online tool and Jamovi software (version 2.4.8.0) were used to analyse the data, and the results were presented as prevalence and 95% confidence intervals.

RESULTS

Thirty-four cross-sectional studies identified from the databases were deemed relevant. The overall sample size was 21,143 PLWHIV on ART in African countries. The analysed data showed the prevalence of depression to be 36%, with 95% CI (27% to 40%), p < 0.01, in Africa. However, the subgroup showed that the highest prevalence was in Northern Africa, with a prevalence of 41% with 95% CI (20% to 50%), p < 0.01, followed by those in Southern and Eastern Africa, with a prevalence of 38% with 95% CI (27% to 49%) and 39% with 95% CI (26% to 50%), p < 0.01, respectively. The lowest prevalence was observed in Western Africa, with a prevalence of 20% with 95% CI (14% to 27%), p < 0.01.

CONCLUSIONS

Our findings show that there is a higher prevalence of depression among PLWHIV who are on ART in Africa. It is crucial to correctly recognise and provide proper care for depression to optimise HIV treatment and enhance treatment adherence in this population.

Psychological profiles among people with HIV: A latent profile analysis and examination of the relationship with interpersonal personality

People living with HIV (PWH) often experience an increased vulnerability to psychiatric disorders as a result of social stigma and discrimination. This study utilized latent profile analysis on a sample of 3040 Chinese PWH to identify distinct psychological profiles. Furthermore, the study investigated the relationships between these profiles with interpersonal personalities, demographic characteristics, social variables and disease-related variables using a three-step regression (R3STEP). The findings from the latent profile analysis revealed that the psychological symptoms of PWH can be categorized into three distinct classes. Multinomial logistic regression analysis indicated that interpersonal personalities, region, sex, age, religious beliefs, marital status, occupation, monthly income, time of HIV infection diagnosis and transmission route were significant factors associated with the psychological profiles of PWH. These findings provide valuable insights for the development of individualized management strategies for PWH and contribute to a deeper understanding of the mechanisms underlying psychological symptoms of PWH.

Prevalence, risk factors and management of common mental health disorders in Cameroon: a systematic review

Objectives

This review aimed to synthesise evidence on (1) the prevalence of common mental health disorders (MHDs) in Cameroon; (2) the effectiveness of mental health management interventions; (3) the risk factors for common MHDs in Cameroon and (4) map the state of research on common mental disorders in Cameroon.

Design

A systematic review.

Data sources

We performed a comprehensive search for articles in major public health databases including PubMed, Scopus, Medline, CINAHL, PsycINFO, Web of Science, Embase, CINAHL from inception of each database to June 2022.

Eligibility criteria

Published articles on the prevalence, risk factors or intervention for management of common MHDs in Cameroon met the inclusion criteria for this systematic review.

Data extraction and synthesis

The abstract and full-text screening, and data extraction were performed independently by at least two researchers. The results have been reported based on a narrative synthesis.

Results

After the screening stages, 32 articles met the inclusion criteria and were included in this study. A high prevalence of common MHDs among different groups, including teenage mothers, students and people living with HIV, was observed. We identified important risk factors for these conditions in the general population and among high-risk groups. We also identified two interventions which show promising results for the management of depression among individuals with HIV in Cameroon.

Conclusion

Our review recorded a high prevalence of common MHDs and identified important risk factors for MHDs among different groups. Increased priority and participatory action with all stakeholders including individuals, communities/policy holders and in research where a huge gap remains to be filled, is crucial in reducing the burden of MHDs in Cameroon.

PROSPERO registration number

CRD42022348427.

The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Background

Non-communicable diseases (NCDs) are increasing among people living with HIV (PLHIV), especially in Sub-Saharan Africa (SSA). We determined the prevalence of NCDs and NCD risk factors among PLHIV in SSA to inform health policy makers.

Methods

We conducted a systematic review and meta-analysis on the prevalence of NCDs and risk factors among PLHIV in SSA. We comprehensively searched PubMed/MEDLINE, Scopus, and EBSCOhost (CINAHL) electronic databases for sources published from 2010 to July 2023. We applied the random effects meta-analysis model to pool the results using STATA. The systematic review protocol was registered on PROSPERO (registration number: CRD42021258769).

Findings

We included 188 studies from 21 countries in this meta-analysis. Our findings indicate pooled prevalence estimates for hypertension (20.1% [95% CI:17.5-22.7]), depression (30.4% [25.3-35.4]), diabetes (5.4% [4.4-6.4]), cervical cancer (1.5% [0.1-2.9]), chronic respiratory diseases (7.1% [4.0-10.3]), overweight/obesity (32.2% [29.7-34.7]), hypercholesterolemia (21.3% [16.6-26.0]), metabolic syndrome (23.9% [19.5-28.7]), alcohol consumption (21.3% [17.9-24.6]), and smoking (6.4% [5.2-7.7]).

Interpretation

People living with HIV have a high prevalence of NCDs and their risk factors including hypertension, depression, overweight/obesity, hypercholesterolemia, metabolic syndrome and alcohol consumption. We recommend strengthening of health systems to allow for improved integration of NCDs and HIV services in public health facilities in SSA. NCD risk factors such as obesity, hypercholesterolemia, and alcohol consumption can be addressed through health promotion campaigns. There is a need for further research on the burden of NCDs among PLHIV in most of SSA.

Funding

This study did not receive any funding.

Age-varying Associations of Depressive Symptoms and Heavy Episodic Drinking Throughout Adulthood Among People with HIV and Receiving care in Cameroon Within a National "treat all" Policy

Comorbid depression and heavy episodic drinking (HED) may threaten the success of "treat all" policies in sub-Saharan Africa as the population of people with HIV (PWH) ages. We investigated associations between depressive symptoms and heavy episodic drinking (HED) and the extent the relationship differed across ages among PWH receiving HIV care in Cameroon. We conducted a retrospective analysis of 18-60-year-old PWH on antiretroviral therapy in Cameroon from January 2016 to March 2020. Age-varying effect modelling was conducted to assess associations between depressive symptoms and HED across ages and by gender. Prevalence of depression and HED was highest at ages 20 and 25, respectively. After age 25, the magnitude of the association between depressive symptoms and HED was significant and increased until age 30 (aOR: 1.88, 95% CI: 1.48, 2.39), with associations remaining significant until age 55 (aOR: 1.64, 95% CI: 1.17, 2.29). Women had more variability and higher magnitudes of associations between depressive symptoms and HED than men. The interrelationship between depressive symptoms and HED was significant throughout most of adulthood for PWH receiving HIV care in Cameroon. Understanding age and gender trends in these associations can guide integration efforts in HIV care settings.

Prevalence and related factors of depressive symptoms among HIV/AIDS in Ningbo, China: A cross-sectional study

BACKGROUND

Depressive symptoms were common among HIV/AIDS patients. Previous studies had shown that HIV-infected patients were twice as likely to be diagnosed with depression as the general population. However, only few studies have explored the prevalence and related factors of depressive symptoms among HIV/AIDS in China.

MATERIALS AND METHODS

A cross-sectional study was conducted to study the prevalence of depressive symptoms among HIV/AIDS from January to December 2021 through the database of HIV/AIDS antiretroviral therapy and psychological evaluation system in Ningbo, China. The Patient Health Questionnaire-2 (PHQ-2) was used to screen for depressive symptoms (PHQ-2 > 0), the Patient Health Questionnaire-9 (PHQ-9) was used to diagnose depressive symptoms, and multivariate Logistic regression model was carried on to evaluate the related factors.

RESULTS

A total of 3,939 HIV/AIDS patients were enrolled, and the age of initiation of antiretroviral therapy was 37.15 (IQR = 28.41-48.73) years. Among them, 3,230 (82.00%) were male, 3,844 (97.59%) were Han nationality, 1,391 (35.49%) were unmarried, 1,665 (42.27%) were homosexual transmission, and 2,194 (55.70%) were HIV-infected patients. There were 265 patients (6.73%) with depressive symptoms, and the proportion of mild, moderate, moderate and severe depressive symptoms was 4.01% (158/3939), 1.65% (65/3939), 0.76% (30/3939), and 0.30% (12/3939), respectively. Multivariate analysis showed that married [odds ratio (OR) = 0.675, 95% CI = 0.501-0.908], divorced or widowed (OR = 0.571, 95% CI = 0.380-0.860), homosexual transmission (OR = 1.793, 95% CI = 1.349-2.396) were associated with depressive symptoms among HIV/AIDS.

CONCLUSION

The prevalence of depressive symptoms among HIV/AIDS patients was 6.73% in Ningbo, China. More attention should be paid to the psychological status of unmarried and homosexual HIV/AIDS patients in Ningbo and timely psychological intervention or treatment should be given to those patients with depressive symptoms.