Prevalence of depression among HIV positive adults on antiretroviral therapy in O.R. Tambo District, Eastern Cape, South Africa: A descriptive cross-sectional study

Abstract

Living with HIV/AIDS is associated with negative emotional as well as bodily symptoms; however, there is a paucity of data on the prevalence and associated factors of depression among this population. This study examined the prevalence and factors contributing to depression among HIV-positive adults on antiretroviral therapy (ART) in O.R. Tambo district of the Eastern Cape, South Africa. This descriptive cross-sectional study involved 334 adults receiving ART in the two Community Health Centers in O.R. Tambo district. Beck’s Depression Inventory (BDI-II) and a semi-structured questionnaire on coping mechanisms and challenges in seeking help with depressive symptoms, were used to collect data. Multiple logistic regression analysis was used to assess the factors associated with depression among the HIV-positive adults. The prevalence of depression among the HIV-positive adults on ART was 44%, and this fell within the borderline and moderate threshold for the majority of the patients. The prevalence of depression was significantly higher among females (71.0%; p < 0.0003) and unemployed (73.0%; p < 0.0014) patients, with participants not benefiting from any form of social grant exhibiting highest prevalence of depression (79%). Participants’ race (p=0.590), age (p=0.338) and marital status (p=0.511) showed no statistically significant associations with depression. The unadjusted logistic regression model showed that being female (OR = 1.99, 95% CI: 1.23-3.23; p < 0.003) and unemployed (OR =1.73, 95% CI: 1.08-2.77; p < 0.014) were significantly associated with a likelihood of depression. Most of the participants who could express their feelings about HIV disease and challenges faced in accessing ART were more depressed (85%) than those who were conservative about their feelings. The high rate of depression among HIV/AIDS patients on ART warrants the need for its early detection, not only to ease the challenges associated with accessing treatment and improving compliance, but also to promote overall quality of life.

Keywords: Depression, HIV positive adults, anti-retroviral therapy, O.R. Tambo District, South Africa.