den Boer Li Xiang Y, Scheuermaier Karine, Tempelman Hugo A, Barth Roos E, Devillé Walter L J M, Coutinho Roel A, Grobbee Diederick E, Venter Francois, Vos-Seda Alinda G, Klipstein-Grobusch Kerstin
Julius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Sci Rep. 2025 Feb 6;15(1):4539. doi: 10.1038/s41598-025-85830-5.
HIV majorly contributes to the disease burden in South Africa. Depressive symptoms are common in people living with HIV (PLHIV). Few studies compared depressive symptoms between PLHIV and those without HIV. The aim of the study was to examine the association of HIV status and depressive symptoms. Moreover, the study aimed to explore the comparison between HIV-negative participants and the different HIV-positive sub-groups regarding their depressive symptoms. A cross-sectional analysis was conducted among PLHIV and HIV-negative participants in rural South Africa, using the baseline data of the Ndlovu Cohort study. Data was collected on demographics, socioeconomic status, and depressive symptoms using the PHQ-9 questionnaire. A score of 10 and above indicated depressive symptoms. Logistic regression analysis on the relationship between HIV status and depressive symptoms was used while adjusting for age, sex, level of education, employment status, income, and ever smoking. The study included 1,927 participants; 46% were PLHIV and 239 (12.5%) had depressive symptoms. PLHIV were more likely to have depressive symptoms than HIV-negative participants (OR 1.34, 95% CI 1.01-1.77). This association was not statistically significant after adjusting for confounders (OR 1.22, 95% CI 0.92-1.63). Compared to HIV-negative participants, ART (antiretroviral treatment) naïve participants had statistically significant higher odds of depressive symptoms (OR 1.84, 95% CI 1.20-2.78). This association remained after adjusting for confounders (OR 1.72, 95% CI 1.11-2.61). There was no statistically significant difference in depressive symptoms between HIV-negative participants and those on ART, regardless of treatment regimen. In general, higher odds of depressive symptoms in ART-naïve PLHIV could reflect poor coping with diagnosis of HIV. Future research to investigate the relation between ART regimen and depressive symptoms, to establish causality and to identify changes over time, is warranted.
在南非，艾滋病病毒对疾病负担有重大影响。抑郁症状在艾滋病病毒感染者（PLHIV）中很常见。很少有研究比较艾滋病病毒感染者与未感染艾滋病病毒者的抑郁症状。本研究的目的是探讨艾滋病病毒感染状况与抑郁症状之间的关联。此外，该研究旨在探讨艾滋病病毒阴性参与者与不同艾滋病病毒阳性亚组在抑郁症状方面的比较。利用恩得洛武队列研究的基线数据，对南非农村地区的艾滋病病毒感染者和艾滋病病毒阴性参与者进行了横断面分析。使用PHQ - 9问卷收集了人口统计学、社会经济状况和抑郁症状的数据。得分10分及以上表明有抑郁症状。在调整年龄、性别、教育水平、就业状况、收入和吸烟史的同时，对艾滋病病毒感染状况与抑郁症状之间的关系进行了逻辑回归分析。该研究包括1927名参与者；46%为艾滋病病毒感染者，239人（12.5%）有抑郁症状。艾滋病病毒感染者比艾滋病病毒阴性参与者更有可能出现抑郁症状（比值比1.34，95%置信区间1.01 - 1.77）。在调整混杂因素后，这种关联无统计学意义（比值比1.22，95%置信区间0.92 - 1.63）。与艾滋病病毒阴性参与者相比，未接受抗逆转录病毒治疗（ART）的参与者出现抑郁症状的几率在统计学上显著更高（比值比1.84，95%置信区间1.20 - 2.78）。在调整混杂因素后，这种关联仍然存在（比值比1.72，95%置信区间1.11 - 2.61）。艾滋病病毒阴性参与者与接受抗逆转录病毒治疗者在抑郁症状方面无统计学显著差异，无论治疗方案如何。一般来说，未接受抗逆转录病毒治疗的艾滋病病毒感染者出现抑郁症状的几率较高，这可能反映出他们对艾滋病病毒诊断的应对能力较差。有必要开展进一步研究，以调查抗逆转录病毒治疗方案与抑郁症状之间的关系，确定因果关系，并确定随时间的变化情况。
