Effectiveness of depression interventions for people living with HIV in Sub-Saharan Africa: A systematic review & meta-analysis of psychological & immunological outcomes.

Journal: Brain, behavior, and immunity

Volume: 73

Issue: 

Year of Publication: 2019

Affiliated Institutions:  University of Cape Town, Department of Psychiatry and Mental Health, Anzio Road, Observatory, Cape Town, South Africa. Electronic address: ruthpasschier@gmail.com. Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Camberwell, London SE AF, United Kingdom. Vrije Universiteit Amsterdam, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Netherlands. Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London SE RT, United Kingdom.

Abstract summary 

This meta-analytic review evaluated the effectiveness of depression interventions on the psychological and immunological outcomes of people living with HIV in sub-Saharan Africa. 14 studies, yielding 932 participants were eligible. A random-effects models indicated that depression interventions were followed by large reductions in depression scores (effect size = 1.86, 95% CI = 1.71, 2.01, p < 0.01). No significant effect on immune outcome was observed, however there was a trend toward immune improvement of medium effect size (effect size on CD4 count and/or viral suppression = 0.57, 95% CI = -0.06, 1.20, p = 0.08). Pharmacological interventions appeared to have a significantly larger improvement in depression scores than psychological interventions. The greatest improvement in immune status was demonstrated in psychological treatments which incorporated a component to enhance HIV medication adherence, however these results did not reach significance. Small sample sizes and highly heterogeneous analysis necessitate caution in interpretation. The results of this meta-analysis should thus be treated as preliminary evidence and used to encourage further studies of immunopsychiatry in HIV in sub-Saharan Africa.

Authors & Co-authors:  Passchier Ruth Verity RV Abas Melanie Amna MA Ebuenyi Ikenna D ID Pariante Carmine M CM

Study Outcome 

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Citations : 
Authors :  4
Identifiers
Doi : 10.1016/j.bbi.2018.05.010
SSN : 1090-2139
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
CD4;Depression;HIV/AIDS;Immunopsychiatry;Intervention;Meta-analysis;Psychoneuroimmunology;Review;Sub-Saharan Africa;Viral load
Study Design
Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
Netherlands