Zeleke Tadele Amare, Ayele Tadesse Awoke, Denu Zewditu Abdissa, Mwanri Lillian, Azale Telake
Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
AIDS Behav. 2025 Jun 24. doi: 10.1007/s10461-025-04787-8.
Depression is highly prevalent among women living with HIV (WLHIV) and is linked to poor quality of life (QoL), impaired functioning, and negative treatment outcomes. While studies in high-income settings report strong associations between depression, stigma, social support, and QoL, evidence from low-resource contexts such as Ethiopia remains limited. This study examined the relationship between depression and QoL among 627 WLHIV on stable antiretroviral therapy (ART) for at least six months. Data were collected prospectively at three-month intervals between September 2023 and April 2024 using structured interviews. Validated tools assessed depression (PHQ-9), HIV-related stigma, social support (Oslo scale), and QoL (WHOQOL-HIV BREF-Eth-27). Repeated measures ANOVA and linear mixed-effects models evaluated QoL trajectories and the impact of depression while adjusting for confounders. Depression was significantly associated with lower scores across all QoL domains: general (β = -0.06, p = 0.000), physical (β = -0.22, p = 0.000), psychological (β = -0.25, p=), spiritual (β = -0.08, p = 0.000), independence (β = -0.13, p = 0.000), environmental (β = -0.23, p = 0.000), and social (β = -0.09, p = 0.000). Non-adherence to ART also negatively affected multiple domains, including general (β = -0.28, p = 0.035), physical (β = -0.51, p = 0.031), psychological (β = -0.72, p = 0.003), social (β = -0.50, p = 0.006), and environmental (β = -0.97, p = 0.015). HIV-related stigma reduced QoL in six domains, while greater social support was positively associated with all domains. These findings underscore the urgent need to address depression, stigma, and ART adherence while promoting social support to improve QoL among WLHIV in Ethiopia.
抑郁症在感染艾滋病毒的女性（WLHIV）中非常普遍，并且与生活质量（QoL）差、功能受损和负面治疗结果相关。虽然高收入环境中的研究报告了抑郁症、耻辱感、社会支持和生活质量之间的强烈关联，但来自埃塞俄比亚等资源匮乏环境的证据仍然有限。本研究调查了627名接受稳定抗逆转录病毒治疗（ART）至少六个月的感染艾滋病毒女性中抑郁症与生活质量之间的关系。在2023年9月至2024年4月期间，每隔三个月通过结构化访谈前瞻性收集数据。使用经过验证的工具评估抑郁症（PHQ-9）、与艾滋病毒相关的耻辱感、社会支持（奥斯陆量表）和生活质量（WHOQOL-HIV BREF-Eth-27）。重复测量方差分析和线性混合效应模型在调整混杂因素的同时评估生活质量轨迹和抑郁症的影响。抑郁症与所有生活质量领域的较低得分显著相关：总体（β = -0.06，p = 0.000）、身体（β = -0.22，p = 0.000）、心理（β = -0.25，p =）、精神（β = -0.08，p = 0.000）、独立性（β = -0.13，p = 0.000）、环境（β = -0.23，p = 0.000）和社会（β = -0.09，p = 0.000）。不坚持抗逆转录病毒治疗也对多个领域产生负面影响，包括总体（β = -0.28，p = 0.035）、身体（β = -0.51，p = 0.031）、心理（β = -0.72，p = 0.003）、社会（β = -0.50，p = 0.006）和环境（β = -0.97，p = 0.015）。与艾滋病毒相关的耻辱感降低了六个领域的生活质量，而更多的社会支持与所有领域呈正相关。这些发现强调了在埃塞俄比亚促进社会支持以改善感染艾滋病毒女性的生活质量的同时，迫切需要解决抑郁症、耻辱感和抗逆转录病毒治疗依从性问题。
