Yakob Tagese, Yakob Begidu, Abraham Awoke, Israel Eskinder
School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia.
BMC Psychiatry. 2025 Sep 1;25(1):845. doi: 10.1186/s12888-025-07345-7.
Depression is one of the most prevalent mental health disorders among people living with human immunodeficiency virus (PLHIV), with studies estimating depression prevalence in PLHIV remains high (24–42%) in sub-Saharan Africa, nearly twice the rate observed in the general population. Primary health care settings in sub-Saharan Africa often lack standardized mental health screening tools, leading to under diagnosis and untreated depression in PLHIV. This study aims to address this gap by examining the factors associated with depression among PLHIV in n primary health care of Southern Ethiopia
A facility-based cross-sectional study was carried out in primary health care setting among adult PLHIV on follow for antiretroviral from January to June of 2023 in Wolaita zone, Southern Ethiopia. A total of 342 sampled adult PLHIV who was registered with an antiretroviral therapy (ART) were included into the study through systematic sampling techniques. Data were collected through face-to-face interviews using structured questionnaires and medical record reviews. Outcome variables (depression symptoms) were assessed using the validated Patient Health Questionnaire-9 (PHQ-9) tool with cutoff score ≥ 10, while exposure variables (clinical/historical factors) were obtained through both self-report and clinical records, with all instruments pretested for local appropriateness. Data were analyzed using STATA version 14, employing bivariate and multivariable logistic regression ( < 0.05 significance) with 95% confidence intervals, preceded by tests for multicollinearity (variance inflation factors < 10) and model fit (Hosmer–Lemeshow = 0.634).
The study included 334 participants, achieving a 97.6% response rate. The prevalence of depression was 30.2% (95% CI: 25.52–35.40). Significant predictors of depression included: age 30–39 years (AOR = 6.40, 95% CI: 1.71–23.9), history of hospital admission (AOR = 3.37, 95% CI: 1.79–6.33), ART duration < 12 months (AOR = 0.26, 95% CI: 0.12–0.58), presence of opportunistic infections (AOR = 2.63, 95% CI: 1.36–5.08), and CD4-positive T cells count ≥ 350 cells/mm (AOR = 0.33, 95% CI: 0.12–0.91).
This study found a high depression prevalence (30.2%, 95% CI: 25.52–35.40) among PLHIV, exceeding general population rates and aligning with WHO reports. Integrating routine mental health screening into ART clinics and providing targeted support for groups with higher odds of depression (younger patients, those hospitalized, or with opportunistic infections) is recommended. Multisectoral collaboration with social services and community organizations may help address stigma (reported by 59.6%) and strengthen social support systems.
抑郁症是人类免疫缺陷病毒感染者（PLHIV）中最常见的心理健康障碍之一。研究估计，撒哈拉以南非洲地区PLHIV的抑郁症患病率仍然很高（24%-42%），几乎是普通人群患病率的两倍。撒哈拉以南非洲地区的初级卫生保健机构往往缺乏标准化的心理健康筛查工具，导致PLHIV的抑郁症诊断不足和未得到治疗。本研究旨在通过调查埃塞俄比亚南部n初级卫生保健机构中PLHIV抑郁症的相关因素来填补这一空白。
2023年1月至6月，在埃塞俄比亚南部沃莱塔地区的初级卫生保健机构中，对接受抗逆转录病毒治疗随访的成年PLHIV进行了一项基于机构的横断面研究。通过系统抽样技术，共纳入342名登记接受抗逆转录病毒治疗（ART）的成年PLHIV作为研究对象。通过面对面访谈使用结构化问卷和病历审查收集数据。使用经过验证的患者健康问卷-9（PHQ-9）工具评估结果变量（抑郁症状），临界值分数≥10，而暴露变量（临床/历史因素）通过自我报告和临床记录获得，所有工具均进行了本地适用性预测试。使用STATA 14版进行数据分析，采用双变量和多变量逻辑回归（显著性<0.05），95%置信区间，之前进行多重共线性检验（方差膨胀因子<10）和模型拟合检验（Hosmer-Lemeshow=0.634）。
该研究纳入了334名参与者，应答率为97.6%。抑郁症患病率为30.2%（95%CI：25.52-35.40）。抑郁症的显著预测因素包括：年龄30-39岁（调整后比值比[AOR]=6.40，95%CI：1.71-23.9）、住院史（AOR=3.37，95%CI：1.79-6.33）、ART治疗时间<12个月（AOR=0.26，95%CI：0.12-0.58）、存在机会性感染（AOR=2.63，95%CI：1.36-5.08）以及CD4阳性T细胞计数≥350个细胞/mm³（AOR=0.33，95%CI：0.12-0.91）。
本研究发现PLHIV中抑郁症患病率较高（30.2%，95%CI：25.52-35.40），超过了普通人群患病率，与世界卫生组织的报告一致。建议将常规心理健康筛查纳入ART诊所，并为抑郁症患病几率较高的群体（年轻患者、住院患者或有机会性感染的患者）提供有针对性的支持。与社会服务和社区组织的多部门合作可能有助于消除耻辱感（59.6%的人报告有耻辱感）并加强社会支持系统。
