Knowledge of HIV Status Is Associated With a Decrease in the Severity of Depressive Symptoms Among Female Sex Workers in Uganda and Zambia.

Journal: Journal of acquired immune deficiency syndromes (1999)

Volume: 83

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  Department of Global Health, University of Washington, Seattle, WA. International Research Consortium, Kampala, Uganda. John Snow, Inc., Lusaka, Zambia. Uganda Health Marketing Group, Kampala, Uganda. Massachusetts General Hospital Global Health, Boston, MA. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA. Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA.

Abstract summary 

Knowledge of HIV-positive status may result in depressive symptoms, which may be a concern to scaling novel HIV testing interventions that move testing outside the health system and away from counselor support.Uganda and Zambia.We used longitudinal data from 2 female sex worker (FSW) cohorts in Uganda (n = 960) and Zambia (n = 965). Over 4 months, participants had ample opportunity to HIV testing using standard-of-care services or self-tests. At baseline and 4 months, we measured participants' perceived knowledge of HIV status, severity of depressive symptoms (continuous PHQ-9 scale, 0-27 points), and prevalence of likely depression (PHQ-9 scores ≥10). We estimated associations using individual fixed-effects estimation.Compared with unknown HIV status, knowledge of HIV-negative status was significantly associated with a decrease in depressive symptoms of 1.06 points in Uganda (95% CI -1.79 to -0.34) and 1.68 points in Zambia (95% CI -2.70 to -0.62). Knowledge of HIV-positive status was significantly associated with a decrease in depressive symptoms of 1.01 points in Uganda (95% CI -1.82 to -0.20) and 1.98 points in Zambia (95% CI -3.09 to -0.88). The prevalence of likely depression was not associated with knowledge of HIV status in Uganda but was associated with a 14.1% decrease with knowledge of HIV-negative status (95% CI -22.1% to -6.0%) and a 14.3% decrease with knowledge of HIV-positive status (95% CI -23.9% to -4.5%) in Zambia.Knowledge of HIV status, be it positive or negative, was significantly associated with a decrease in depressive symptoms in 2 FSW populations. The expansion of HIV testing programs may have mental health benefits for FSWs.

Authors & Co-authors:  Ortblad Katrina F KF Musoke Daniel Kibuuka DK Chanda Michael M MM Ngabirano Thomson T Velloza Jennifer J Haberer Jessica E JE McConnell Margaret M Oldenburg Catherine E CE Bärnighausen Till T

Study Outcome 

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Citations :  Baral S, Beyrer C, Muessig K, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:538–549.
Authors :  9
Identifiers
Doi : 10.1097/QAI.0000000000002224
SSN : 1944-7884
Study Population
Female
Mesh Terms
Adult
Other Terms
Study Design
Study Approach
Country of Study
Uganda
Publication Country
United States