Depression In Newly Diagnosed People Living With Hiv In Kilimanjaro Region: Prevalence, Severity And Associated Factors

Abstract

Human Immunodeficiency Virus (HIV) has been shown to increase susceptibility to mental health issues, with Depression being the most common associated illness. The event of being diagnosed with HIV can be considered a Stressful Life Event and, therefore, being newly diagnosed with HIV could be associated with the incidence of Depression. To the best of my knowledge no studies in Tanzania have systematically explored the associations between recent HIV diagnosis (within the past 12 months), prevalence and severity of Depression and its associated factors. Objectives: To determine prevalence and severity of Depression, and associated factors among newly diagnosed PLHIV attending CTC centres in Kilimanjaro Region Methodology: Cross-sectional hospital-based using quantitative methods and utilizing the Patient Health Questionnaire-9 (PHQ-9) as a screener and diagnostic tool for Depression, Demographic Health Survey (SES-DHS8) for socio-demographic characteristics, Patient records for other associated factors, Duke-UNC Functional Social Support Questionnaire (FSSQ) to assess perceived social support and a Stressful Life Events checklist. 272 participants diagnosed with HIV within the past 12 months were sampled consecutively. Analysis was conducted using STATA v16. Univariate analysis, Chi-square and Analysis of Variance (ANOVA) for Bivariate analysis, and Ordinal logistic regression for Multivariate analysis with a 95% confidence interval and p<0.05 were conducted. xii Results: 106 (38.97%) participants were male and 166 (61.03%) female. Mean age was 41 (SD12.25) years. Overall prevalence of Depression was 41.18%; 54 (19.85%): moderate, 42 (15.44%): moderately severe and 16 (5.88%): severe Depression. Severity was highest in participants diagnosed with HIV less than 1 month ago. ANOVA revealed significant variance (F-ratio = 10.45) between the severity of Depression at different durations post-HIV diagnosis (p=0.00). Study site (Reference: Mawenzi. Majengo: p=0.007, Hai: p=0.001), no/informal education (Primary: p=0.02, Secondary: 0.05, Higher: 0.04) and those with <1-month anti-retroviral therapy (Reference: <1 month, 1-3 months: p=0.001, 3-6 months: 0.00, 6-12 months: 0.00) were more likely to have Depression. Conclusion: The study clearly answers questions on prevalence, severity and associated factors of Depression, while also confirming the alternative hypothesis in that there is an association between being newly diagnosed with HIV and the presence of clinically significant depressive symptoms. This indicates that integration of mental health interventions into CTC care is pertinent. However, this study raises further questions on how to address this issue of Depression among newly diagnosed PLHIV. Recommendations: Integration of interventions for improved detection and treatment of Depression such as routine screening of PLHIV for Depression from time of enrollment into CTC care, and offering appropriate linkage to treatment services where necessary. Developing brief manuals for clinicians on assessing Depression may also be useful. Prospective studies could help to identify patterns of Depression among a cohort of newly diagnosed clients.