Common mental disorders (CMD) are common in people with HIV. Depression adds to the burden of disease experienced, contributes to difficulties with medication adherence as well as self care skills; and increases the risks of morbidity and mortality. In this paper we have tried to determine risk factors for incident and persistent CMD in people living with HIV (PLHIV) in developing countries.
This was a one year longitudinal study of PLHIV who agreed to participate in the ASHA community based intervention programme in Goa, India. Data was collected at baseline and after the participants had received the intervention for at least 12 months. Data was collected on sociodemographic factors, HIV related health (e.g. CD4 count), HIV related care (satisfaction with care), attendance at support groups and mental health. Multivariate analyses were undertaken to examine the predictors of persistent CMD and incident CMD. Of the 162 participants eligible for the end-line assessment at one year, 102 (63%) agreed to participate. 21.6% had incident CMD and 23.5% had persistent CMD. On multivariate analyses, the statistically significant predictors of incident CMD were requiring ART (RR 2.82; 95% CI 1.11–7.15), female gender (RR 11.79; 95% CI 2.34–59.23) and unemployment (RR 4.29; 95% CI 1.62–11.35). On multivariate analyses, the statistically significant predictors of persistent CMD were lack of satisfaction with care (RR 5.06; 95% CI 1.79–14.28) and female gender (RR 6.47; 95% CI 2.09–19.99). Certain sub groups of PLHIV are at an increased risk of new and persistent depression and consequently would benefit from more intensive mental health input. Mental health care must be integrated into HIV and AIDS care programme in low-income countries and delivered by non-specialist health workers in low-resource settings.
- Common Mental Disorder
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