Prevalence and correlates of depression among people living with HIV on Atazanavir based second line regimens at a Tertiary Teaching and Referral Hospital in Kenya

Abstract

Objectives: To determine the prevalence and correlates of depression in patients on second line anti-retroviral therapy.
Design: A cross sectional study.
Setting: The HIV care clinic in Kenyatta National Hospital, Nairobi, Kenya.
Subjects: Adult HIV positive patients on atazanavir based second line regimens.
Intervention: Administration of the 9 item Patient Health Questionnaire
Main outcome measure: Prevalence of depression in the study population
Results: Between October and November 2017, we enrolled 110 patients, of whom 46 (41.8%) were male and 64 (58.2%) were female. The mean age was 39.8 years (± 11.8); slightly more than half were married (53.6%, 59) and approximately half had completed high school (50.9%, 56). The median CD4 count was 219 (IQR=272) and half of the participants had attained viral suppression. Forty percent (n = 95) of the participants had varying severities of depression (mild, minimum and moderate) though none had major depressive disorder. Having gainful employment (aOR 0.18, 95% CI 0.04 – 0.62), being on treatment for long (aOR 0.77, 95% CI 0.60 – 0.98) and being adherent to therapy (aOR 0.23, 95% CI 0.05 – 0.95) lowered the risk of screening positive for depression whereas an ongoing opportunistic infection increased the risk (aOR 6.81, 95% 1.24 – 55.48).
Conclusion: There is a high burden of possible depression among patients on second line antiretroviral regimens that is associated with occupation, duration of antiretroviral therapy, adherence and current opportunistic infections.