Depressive Symptoms, the Impact on ART Continuation, and Factors Associated with Symptom Improvement Among a Cohort of People Living with HIV in British Columbia, Canada

• Published in: AIDS and behavior Vol. 28; no. 1; pp. 43 - 58
• Main Authors: Pakhomova, Tatiana E., Tam, Clara, Wang, Lu, Salters, Kate, Moore, David M., Barath, Justin, Elterman, Simon, Dawydiuk, Nicole, Wesseling, Tim, Grieve, Sean, Sereda, Paul, Hogg, Robert, Barrios, Rolando
• Format: Journal Article
• Language: English
• Published: New York Springer US 2024; Springer Nature B.V
• Subjects: Adult; Antiretroviral agents; Antiretroviral therapy; British Columbia - epidemiology; Cocaine; Depression - diagnosis; Depression - epidemiology; Epidemiology; Health planning; Health Psychology; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infectious Diseases; Longitudinal Studies; Measures; Medical treatment; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Mental Disorders - complications; Mental health; Mental health services; Original Paper; Public Health; Regression models; Symptomology; Symptoms; Well being; Young Adult; British Columbia; British Columbia Canada; Canada; HIV/AIDS; HIV care; Depressive symptoms; British Columbia; Mental health
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-023-04156-3

Depressive symptoms among people living with HIV (PLWH) are associated with poorer overall health outcomes. We characterized depressive symptoms and improvements in symptomology among PLWH (≥ 19 years old) in British Columbia (BC), Canada. We also examined associations between depressive symptomology and antiretroviral therapy (ART) treatment interruptions. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), within a longitudinal cohort study with three surveys administered 18-months apart. We used multivariable logistic regression to model factors associated with improvements in depressive symptoms (CES-D-10 scores from ≥ 10 to < 10). Of the 566 participants eligible for analysis 273 (48.2%) had CES-D scores indicating significant depressive symptoms (score ≥ 10) at enrollment. Improvements in symptoms at first follow-up were associated with greater HIV self-care on the Continuity of Care Scale (adjusted odds ratio: 1.17; 95% CI 1.03–1.32), and not having a previously reported mental health disorder diagnosis (aOR 2.86; 95% CI 1.01–8.13). Those reporting current cocaine use (aOR 0.33; 95% CI 0.12–0.91) and having a high school education, vs. less than, (aOR 0.25; 95% CI 0.08–0.82) had lower odds of improvement in depressive symptomatology. CES-D scores ≥ 10 were not significantly associated with ART treatment interruptions during follow-up (aOR: 1.08; 95% CI:0.65–1.8). Supporting greater self-care and consideration of mental health management strategies in relation to HIV may be useful in promoting the wellbeing of PLWH who experience depressive symptoms.