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      Anxiety and Depression Disorder among Adult People Living with HIV/AIDS on Follow-up at Dessie Public Health Facilities Antiretroviral Therapy Clinics, Northeast Ethiopia: A Multicenter Cross-sectional Study

      The Open AIDS Journal
      Bentham Science Publishers Ltd.

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          Abstract

          Background:

          Anxiety and depression are the most prevalent mental disorders among people living with HIV/AIDS compared to people without HIV/AIDS. In addition, mental health problems are associated with an increase in morbidity and mortality in people living with HIV/AIDS due to adverse effects, adherence to antiretroviral therapy, quality of life, and all health-related parameters. There is no additional study on multiple sites as an integrated way to address the proposed issue.

          Objective:

          This study aimed to assess the prevalence of anxiety and depression disorders and their associated factors among adult HIV-/AIDS patients on follow-up at antiretroviral therapy clinics in the Dessie town public health facility, Northeast Ethiopia.

          Methods:

          A multicenter institutional-based descriptive cross-sectional study design was used. Data were collected through face-to-face interviews using a structured questionnaire. Anxiety and depression disorders were assessed by using the Hospital Anxiety and Depression Scale (HADS). EPI-Data software version 7.2 for data entry and SPSS version 23 for statistical analysis were used. Statistical significance was declared at a p-value of <0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) in the final model.

          Results:

          In this study, 404 adult HIV/-AIDS patients presenting for a follow-up at antiretroviral therapy clinics at Dessie town public health facilities participated; the prevalence of anxiety and depression disorders was found to be 31.7% (CI: 27%, 36.6%) and 38% (CI: 33.7%, 42.7%), respectively. Being female (AOR=3.5 95% CI: 1.86 –6.65), viral loads ≥ 1000 copies/ml (AOR =2.2, 95% CI: 1.2-3.95), and CD4 cells <200 cells/mm 3 were associated with depressive disorder and HAART containing efavirenz (2.3 95% CI: 1-4.58), consumption of coffee and tea (AOR =2.5, 95% CI; 1.45 -4.37) and female gender (AOR= 3.5 95% CI; 1.9-6.6), which were found to be predictors for anxiety disorders.

          Conclusion and Recommendations:

          The magnitude of depression in people living with HIV/AIDS on follow-up with antiretroviral therapy was found to be higher than the pooled estimated prevalence found in Ethiopia. Being female, viral load ≥ 1000 copies/ml, and CD4 cells <200 cells/mm 3 were associated with the occurrence of depressive disorders, and a HAART regimen containing efavirenz, taking coffee and tea, and female sex were found to be predictors for anxiety disorder.

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          Most cited references26

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          Stress and depression.

          Improved methods of assessment and research design have established a robust and causal association between stressful life events and major depressive episodes. The chapter reviews these developments briefly and attempts to identify gaps in the field and new directions in recent research. There are notable shortcomings in several important topics: measurement and evaluation of chronic stress and depression; exploration of potentially different processes of stress and depression associated with first-onset versus recurrent episodes; possible gender differences in exposure and reactivity to stressors; testing kindling/sensitization processes; longitudinal tests of diathesis-stress models; and understanding biological stress processes associated with naturally occurring stress and depressive outcomes. There is growing interest in moving away from unidirectional models of the stress-depression association, toward recognition of the effects of contexts and personal characteristics on the occurrence of stressors, and on the likelihood of progressive and dynamic relationships between stress and depression over time-including effects of childhood and lifetime stress exposure on later reactivity to stress.
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            Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales.

            Despite the high prevalence of both mental disorders and HIV infection in much of sub-Saharan Africa, little is known about the occurrence of mental health disorders among HIV-infected individuals. We conducted a cross-sectional study among individuals enrolled into HIV care and treatment services near Cape Town, South Africa. Psychiatric diagnoses were measured using the Mini-International Neuropsychiatric Interview (MINI) administered by trained research nurses. In addition, all participants were administered brief rating scales for depression (the Center for Epidemiological Studies Depression Scale [CES-D]), posttraumatic stress disorder (PTSD), the Harvard Trauma Questionnaire (HTQ), and alcohol dependence/abuse (the Alcohol Use Disorders Identification Test [AUDIT]). The median age among the 465 participants was 33 years and 75% were female; 48% were receiving antiretroviral therapy. Overall, the prevalence of depression, PTSD and alcohol dependence/abuse was 14% (n = 62), 5% (n = 24), and 7% (n = 35), respectively. In multivariate analysis, the prevalence of all disorders was significantly higher among individuals who spoke Afrikaans compared to Xhosa. While the AUDIT showed excellent sensitivity and specificity in detecting MINI-defined dependence/abuse (area under the receiver-operating characteristic curve, 0.96), the HTQ and CES-D had lower performance characteristics in detecting PTSD (0.74) and depression (0.76), respectively. These data demonstrate high levels of depression, PTSD and alcohol dependence/abuse among HIV-infected individuals in this setting. Additional research is required to refine these rating scales for maximum applicability in cross-cultural populations. More generally, HIV care and treatment services represent an important venue to identify and manage individuals with common mental disorders in resource-limited settings.
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              Prevalence and correlates of depression and anxiety among patients with HIV on-follow up at Alert Hospital, Addis Ababa, Ethiopia

              Background Depression and anxiety disorders are common among people living with Human Immunodeficiency Virus than the non-infected individuals. The co-existence of these disorders are associated with barriers to treatment and worsening medical outcomes, including treatment resistance, increased risk for suicide, greater chance for recurrence and utilization of medical resources and/or increase morbidity and mortality. Therefore, assessing depression and anxiety among HIV patients has a pivotal role for further interventions. Methods Institution based cross-sectional study was conducted at ALERT hospital May, 2015. Data were collected using a pretested, structured and standardized questionnaire. Systematic sampling technique was used to select the study participants. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95 % CI was computed to assess the strength of associations. Results The prevalence of co-morbid depression and anxiety among HIV patients was 24.5 % and prevalence of depression and anxiety among HIV patients was 41.2 % (172) and 32.4 % (135) respectively. Multivariate analysis showed that individual who had perceived HIV stigma (AOR = 3.60, 95 % CI (2.23, 5.80), poor social support (AOR = 2.02, 95 % CI (1.25, 3.27), HIV stage III (AOR = 2.80, 95 % CI (1.50, 5.21) and poor medication adherence (AOR = 1.61, 95 % CI (1.02, 2.55) were significantly associated with depression. Being female (AOR = 3.13, 95 % CI (1.80, 5.44), being divorced (AOR = 2.51, 95 % CI (1.26, 5.00), having co morbid TB (AOR = 2.74, 95 % CI (1.37, 5.47) and perceived HIV stigma (AOR = 4.00, 95 % CI (2.40, 6.69) were also significantly associated with anxiety. Conclusion Prevalence of depression and anxiety was high. Having perceived HIV stigma, HIV Stage III, poor social support and poor medication adherence were associated with depression. Whereas being female, being divorced and having co morbid TB and perceived HIV stigma were associated with anxiety. Ministry of health should give training on how to screen anxiety and depression among HIV patients and should develop guidelines to screen and treat depression and anxiety among HIV patients.
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                Author and article information

                Journal
                The Open AIDS Journal
                TOAIDJ
                Bentham Science Publishers Ltd.
                1874-6136
                November 07 2023
                November 07 2023
                : 17
                : 1
                Article
                10.2174/0118746136250239231025074541
                cfc1d872-6ac5-440f-b22e-42454de74d6e
                © 2023

                Free to read

                https://creativecommons.org/licenses/by/4.0/legalcode

                History

                Medicine,Chemistry,Life sciences
                Medicine, Chemistry, Life sciences

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