Prevalence of depression among adults living with and without HIV in Zambia and Zimbabwe: a cross sectional study (2019-2023)
1
Clinic, Newlands Clinic, Harare, Zimbabwe
2
Research, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
People living with HIV (PWLH) have an increased prevalence of mental health symptoms including depression and anxiety due to several societal and psychosocial factors. Despite increasing efforts to integrate noncommunicable disease (NCD) care in HIV programs, mental health screening and intervention remain scarce. In an ongoing HIV-NCD cohort we describe depression at cohort initiation.
METHODS:
We conducted a cross-sectional analysis among newly diagnosed adults (≥30 years) living with HIV who were ART-naïve (≤4-weeks) and adults without HIV from three primary care clinics in urban Zambia and Zimbabwe. Enrolment occurred between July 2019 to January 2023. Depression was measured using the Patient Health Questionnaire (PHQ-9) standardized questionnaire by trained study personnel after HIV-testing at the point of enrolment. We defined moderate-severe depression as a PHQ-9 score of ≥10. Multivariable logistic regression was used to determine factors associated with depression.
RESULTS:
A total of 1059 adults aged ≥30 years were included in the analysis, including 525 ART-naïve PLWH and 534 people without HIV. 489 participants were from Zambia (46%) and 570 from Zimbabwe (54%). Overall, 56% were female, 68% were employed and 62% were married. The median age was 39 years (IQR:34–46), and 168 (16%) were over the age of 50 years. The overall prevalence of depression was 8.3% (95%CI:6.8-10.1%), with 38 of 525 adults (7.2%) living with HIV reporting depressive symptoms. In the bivariate analysis, HIV status and female sex were associated with depressive symptoms. Our multivariable analysis showed an attenuated effect with no significantly associated factors; however, we noted that people living without HIV (aOR 1.29;0.82-2.05;CI;p= 0.272) had higher odds of depression.
CONCLUSIONS:
Overall, at enrolment we report a relatively low prevalence of depression in our cohort. However, there is need for mental health care irrespective of HIV status among the general population in Southern Africa.
People living with HIV (PWLH) have an increased prevalence of mental health symptoms including depression and anxiety due to several societal and psychosocial factors. Despite increasing efforts to integrate noncommunicable disease (NCD) care in HIV programs, mental health screening and intervention remain scarce. In an ongoing HIV-NCD cohort we describe depression at cohort initiation.
METHODS:
We conducted a cross-sectional analysis among newly diagnosed adults (≥30 years) living with HIV who were ART-naïve (≤4-weeks) and adults without HIV from three primary care clinics in urban Zambia and Zimbabwe. Enrolment occurred between July 2019 to January 2023. Depression was measured using the Patient Health Questionnaire (PHQ-9) standardized questionnaire by trained study personnel after HIV-testing at the point of enrolment. We defined moderate-severe depression as a PHQ-9 score of ≥10. Multivariable logistic regression was used to determine factors associated with depression.
RESULTS:
A total of 1059 adults aged ≥30 years were included in the analysis, including 525 ART-naïve PLWH and 534 people without HIV. 489 participants were from Zambia (46%) and 570 from Zimbabwe (54%). Overall, 56% were female, 68% were employed and 62% were married. The median age was 39 years (IQR:34–46), and 168 (16%) were over the age of 50 years. The overall prevalence of depression was 8.3% (95%CI:6.8-10.1%), with 38 of 525 adults (7.2%) living with HIV reporting depressive symptoms. In the bivariate analysis, HIV status and female sex were associated with depressive symptoms. Our multivariable analysis showed an attenuated effect with no significantly associated factors; however, we noted that people living without HIV (aOR 1.29;0.82-2.05;CI;p= 0.272) had higher odds of depression.
CONCLUSIONS:
Overall, at enrolment we report a relatively low prevalence of depression in our cohort. However, there is need for mental health care irrespective of HIV status among the general population in Southern Africa.
| eISSN: | 2654-1459 |
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