The prevalence and outcomes of depression in older HIV-positive adults in Northern Tanzania: a longitudinal study

J Neurovirol. 2023 Aug;29(4):425-439. doi: 10.1007/s13365-023-01140-4. Epub 2023 May 25.

Abstract

Studies of depression and its outcomes in older people living with HIV (PLWH) are currently lacking in sub-Saharan Africa. This study aims to investigate the prevalence of psychiatric disorders in PLWH aged ≥ 50 years in Tanzania focussing on prevalence and 2-year outcomes of depression. PLWH aged ≥ 50 were systematically recruited from an outpatient clinic and assessed using the Mini-International Neuropsychiatric Interview (MINI). Neurological and functional impairment was assessed at year 2 follow-up. At baseline, 253 PLWH were recruited (72.3% female, median age 57, 95.5% on cART). DSM-IV depression was highly prevalent (20.9%), whereas other DSM-IV psychiatric disorders were uncommon. At follow-up (n = 162), incident cases of DSM-IV depression decreased from14.2 to 11.1% (χ2: 2.48, p = 0.29); this decline was not significant. Baseline depression was associated with increased functional and neurological impairment. At follow-up, depression was associated with negative life events (p = 0.001), neurological impairment (p < 0.001), and increased functional impairment (p = 0.018), but not with HIV and sociodemographic factors. In this setting, depression appears highly prevalent and associated with poorer neurological and functional outcomes and negative life events. Depression may be a future intervention target.

Keywords: Depression; HIV-associated neurocognitive disorders; Older adults; Sub-Saharan Africa; Tanzania.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Depression / epidemiology
  • Female
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • HIV Infections* / psychology
  • Humans
  • Longitudinal Studies
  • Male
  • Prevalence
  • Tanzania / epidemiology