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AIDS and Behavior
Published in: AIDS and Behavior 8/2017

01-08-2017 | Original Paper

Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda

Authors: Jennifer Velloza, Connie Celum, Jessica E. Haberer, Kenneth Ngure, Elizabeth Irungu, Nelly Mugo, Jared M. Baeten, Renee Heffron, Partners Demonstration Project Team

Published in: AIDS and Behavior | Issue 8/2017

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Abstract

Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. We followed 1013 HIV-infected individuals participating in the Partners Demonstration Project, an open-label study of integrated pre-exposure prophylaxis (PrEP) and ART delivery for HIV serodiscordant couples in Kenya and Uganda. Associations between depression, measured annually with the Hopkins Symptoms Checklist-Depression (HSCL-D), and ART initiation were assessed with Cox proportional hazards regression. At enrollment, 162 participants (16.0%) reported symptoms consistent with probable depression, defined by a HSCL-D mean score >1.75, and this proportion decreased during study follow-up (6.7 and 3.6% at 12- and 24-months, respectively; p value < 0.001). Greater depressive symptom severity was associated with a greater likelihood of ART initiation overall (adjusted hazard ratio [aHR] 1.32, 95% CI 1.01–1.73) and among participants with CD4 count ≤ 350 cells/µl (aHR 1.30, 95% CI 1.01–1.67). Depression decreased 6 months after ART initiation (adjusted odds ratio [aOR] 0.34, 95% CI 0.23–0.51). Among East African HIV-infected persons in HIV serodiscordant couples, depression was not a barrier to ART initiation. ART initiation was associated with improved depressive symptoms in this setting.
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Metadata
Title
Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda
Authors
Jennifer Velloza
Connie Celum
Jessica E. Haberer
Kenneth Ngure
Elizabeth Irungu
Nelly Mugo
Jared M. Baeten
Renee Heffron
Partners Demonstration Project Team
Publication date
01-08-2017
Publisher
Springer US
Published in
AIDS and Behavior / Issue 8/2017
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-017-1829-z

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