Depression and alcohol use disorder at antiretroviral therapy initiation led to disengagement from care in South Africa.

Journal: PloS one

Volume: 12

Issue: 12

Year of Publication: 2018

Affiliated Institutions:  Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America. Aurum Institute, Johannesburg, South Africa. Private practice clinical psychologist, Johannesburg, South Africa.

Abstract summary 

We sought to assess mental health at the time of antiretroviral therapy (ART) initiation and subsequent retention in care over a six-month follow-up period. A total of 136 people living with HIV in South Africa were administered surveys measuring demographic information and mental health indicators at the time of ART initiation. Follow-up was completed via chart abstraction to assess for six-month outcomes of retention in care and viral suppression. At enrollment, 45/136 (33%), 67/136 (49%), and 45/136 (33%) participants screened positive for depression, anxiety, and alcohol use disorder, respectively. After six months of follow-up, 96/136 (71%) participants remained in care; 35/87 (40.2%) participants who remained in care had a level <50 copies/mL. Those with depression (49% vs. 77% retained; p < 0.01) and those with alcohol use disorder (52% vs. 76% retained; p < 0.01) were less likely to be retained in care. In multivariable logistic regression, depression OR 3.46 (95% CI: 1.33, 7.97; p < 0.01) and alcohol abuse OR 3.89 (95% CI: 1.70, 8.97; p < 0.01) were independently associated with loss from care. These results emphasize the importance of mental health on early ART outcomes and the HIV care continuum.

Authors & Co-authors:  Cichowitz Cody C Maraba Noriah N Hamilton Robin R Charalambous Salome S Hoffmann Christopher J CJ

Study Outcome 

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Statistics
Citations :  AIDS JUNPOH. Global AIDS update 2016. Geneva; 2016.
Authors :  5
Identifiers
Doi : e0189820
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States