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Psychosocial Functioning and Depressive Symptoms Among HIV-Positive Persons Receiving Care and Treatment in Kenya, Namibia, and Tanzania

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Abstract

In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIV attending HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Eighteen HIV care and treatment clinics (six per country) enrolled approximately 200 HIV-positive patients (for a total of 3,538 participants) and collected data on patients’ physical and mental well-being, medical/health status, and psychosocial functioning. Although the majority of participants did not report clinically significant depressive symptoms (72 %), 28 % reported mild to severe depressive symptoms, with 12 % reporting severe depressive symptoms. Regression models indicated that greater levels of depressive symptoms were associated with: (1) being female, (2) younger age, (3) not being completely adherent to HIV medications, (4) likely dependence on alcohol, (5) disclosure to three or more people (versus one person), (6) experiences of recent violence, (7) less social support, and (8) poorer physical functioning. Participants from Kenya and Namibia reported greater depressive symptoms than those from Tanzania. Approximately 28 % of PLHIV reported clinically significant depressive symptoms. The scale-up of care and treatment services in sub-Saharan Africa provides an opportunity to address psychosocial and mental health needs for PLHIV as part of comprehensive care.

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Acknowledgments

The authors would like to express their gratitude to the study interviewers, program coordinators, and data management staff in the three countries without whom this study could not have been completed. The authors would also like to thank the Ministries of Health in Kenya, Tanzania, and Namibia, as well as ICAP and CDC staff in these three countries for all the support they provided to this project. Finally, the authors would like to thank all of the health care providers, lay counselors, and clinic patients that participated in this study for their willingness to share their experiences with us. This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC.

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The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, MS E04, Atlanta, GA, 30333, USA

    Puja Seth, Daniel Kidder, Sherri Pals & Pamela Bachanas

  2. Ministry of Health and Social Services, Windhoek, Namibia

    Julie Parent & Frieda Katuta

  3. Tanzania Health Promotion Support, Dar es Salaam, Tanzania

    Redempta Mbatia

  4. U.S. Centers for Disease Control and Prevention, Nairobi, Kenya

    Kipruto Chesang

  5. U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania

    Deogratius Mbilinyi

  6. ICAP, Nairobi, Kenya

    Emily Koech

  7. Ministry of Health and Social Welfare, Dar es Salaam, Tanzania

    Mathias Nkingwa

  8. Ministry of Health and Social Welfare, Nairobi, Kenya

    Anne Ng’ang’a

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  1. Puja Seth
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Seth, P., Kidder, D., Pals, S. et al. Psychosocial Functioning and Depressive Symptoms Among HIV-Positive Persons Receiving Care and Treatment in Kenya, Namibia, and Tanzania. Prev Sci 15, 318–328 (2014). https://doi.org/10.1007/s11121-013-0420-8

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