Determinants of Depression among HIV Patients Attending the Weija-Gbawe Municipal Hospital in Accra

Abstract

Introduction: Depression is one of the most common psychological disorders experienced by HIV patients. The risk of depression among Persons Living with HIV (PLWHIV) is reported to be 2-5 times the risk among HIV-negative people. This higher risk is believed to be an outcome of several factors, including the impact of the infection itself, the side effects of the Antiretroviral Therapy (ART) drugs, stigma from society, the burden of life-long treatment, and the challenges with an economically productive life, living with the disease. Whilst depression among HIV patients and its consequences on the progression of the disease are well documented, the factors that predispose to depression among this sub-population, particularly in Ghana, have not been explicitly described. This study sought to estimate the prevalence and determinants of depression among PLWHIV attending the Weija-Gbawe Municipal Hospital in Accra. Methods: A cross-sectional study was conducted in Weija/Gbawe Municipal Hospital within the Accra Metropolis of Ghana over a period of 4 weeks. A total of 319 participants’ data were analysed using STATA version 17. Univariate and multivariate logistic regression models were fitted to identify factors associated with depressive symptoms among participants. All variables from the univariate analysis with a p-value <0.1 were entered into a forward-stepwise multivariate logistic regression analysis. All tests were two-tailed and a p< 0.05 was considered statistically significant. Results: The prevalence of depression among HIV-positive patients on HAART in the Accra Metropolis is 58.3%. The participants showed varying degrees of depressive symptoms. Mild depressive symptoms were observed in 14.7% of participants, 24.1% showed moderate depressive symptoms, 11.3% showed moderately severe symptoms of depression and 8.2% showed severe depressive symptoms. The determinants that were significantly associated with an increased risk of depression among PLWHIV were age (AOR= 0.33, 95% CI 0.14-0.77), marital status (AOR= 0.38, 95% CI 0.18-0.81), monthly expenditure (AOR= 7.78, 95% CI 1.49-40.56), being bothered by HIV related comorbidity (AOR 42.78, 95% CI 8.07-226.81), and availability of social support (AOR= 0.31, 95% CI 0.11-0.90). Some of the confidence intervals were very wide suggesting low outcome numbers and hence greater uncertainty around the estimates. Conclusion: These findings suggest that the prevalence of depression is high among PLWHIV and the determinants are mainly age and social factors that are amenable to targeted interventions if management is to improve their treatment outcomes and patients’ well-being.