Depression Worsens Antiretroviral Adherence Worldwide

The pooled prevalence of depressive symptoms and major depression among people with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) worldwide is high and negatively affects antiretroviral adherence, according to an umbrella review published in Frontiers in Psychiatry.

“The pooled odds ratio of adherence among patients with depressive symptoms was 0.54 (0.36, 0.72),” wrote a research team from Ethiopia. “This implied that people living with HIV/AIDS who had depressive symptoms were 46% less adherent to antiretroviral medication as compared to patients who had no depressive symptoms.”

The umbrella review spanned eight systematic reviews of 265 studies investigating depressive symptoms in patients with HIV/AIDS, four systematic reviews of 48 studies investigating major depressive disorder in patients with HIV/AIDS, and six systematic reviews of 442 studies on the effect of depressive symptoms on antiretroviral medication adherence.

A random-effects model found a 34.17% global prevalence of depressive symptoms among people with HIV/AIDS, researchers reported. Meanwhile, the prevalence of major depressive disorder in the four systematic reviews averaged 13.42%.

Depressive symptoms were negatively associated with antiretroviral medication adherence in all six systematic reviews, according to the umbrella review.

“A systematic review and meta-analysis…reported that depressed patients had a loss of self-efficacy and the ability of decision-making capacity for treatment adherence,” researchers wrote.

They recommended the development and implementation of focused interventions to improve adherence despite depression.

Reference:
Necho M, Zenebe Y, Tiruneh C, Ayano G, Yimam B. The global landscape of the burden of depressive symptoms/major depression in individuals living with HIV/AIDs and its effect on antiretroviral medication adherence: an umbrella review. Front Psychiatry. 2022;13:814360. doi:10.3389/fpsyt.2022.814360