eprintid: 10054669
rev_number: 24
eprint_status: archive
userid: 608
dir: disk0/10/05/46/69
datestamp: 2018-08-23 13:23:15
lastmod: 2021-12-06 00:13:41
status_changed: 2018-08-23 13:24:20
type: article
metadata_visibility: show
creators_name: Kinyanda, E
creators_name: Levin, J
creators_name: Nakasujja, N
creators_name: Birabwa, H
creators_name: Nakku, J
creators_name: Mpango, R
creators_name: Grosskurth, H
creators_name: Seedat, S
creators_name: Araya, R
creators_name: Shahmanesh, M
creators_name: Patel, V
title: Major Depressive Disorder: Longitudinal Analysis of Impact on Clinical and Behavioral Outcomes in Uganda
ispublished: pub
divisions: UCL
divisions: B02
divisions: D01
divisions: G16
note: This is an open-access article distributed under the terms of the Creative
Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where
it is permissible to download, share, remix, transform, and buildup the
work provided it is properly cited. The work cannot be used commercially
without permission from the journal.
abstract: Background: There is still wide variability in HIV disease course and other HIV-related outcomes, attributable in part to psychosocial factors such as major depressive disorder (MDD), a subject that has received little attention in sub-Saharan Africa.

Methods: Using a longitudinal cohort of 1099 HIV-positive antiretroviral therapy–naive persons, we investigated the impact of MDD on 4 HIV-related negative outcome domains in Uganda. MDD was assessed using a Diagnostic Statistical Manual IV–based tool. Also collected were data on surrogate measures of the HIV-related outcome domains. Data were collected at the 3 time points of baseline, 6, and 12 months. Multiple regression and discrete time survival models were used to investigate the relationship between MDD and indices of the HIV outcomes.

Results: MDD was a significant predictor of “missed antiretroviral therapy doses” [adjusted odds ratio (aOR) = 4.75, 95% confidence interval (CI): 1.87 to 12.04, P = 0.001], “time to first visit to healthy facility” (aOR = 1.71; 95% CI: 1.07 to 2.73; P = 0.024), “time to first self-reported risky sexual activity” (aOR = 2.11, 95% CI: 1.27 to 3.49; P = 0.004) but not of “CD4 counts at months 6 and 12” (estimated effect 29.0; 95% CI: −7.8 to 65.7; P = 0.12), and “time to new WHO stage 3 or 4 clinical event” (aOR = 0.52, 95% CI: 0.12 to 2.20, P = 0.37).

Conclusions: MDD significantly impacted 3 of the 4 investigated outcome domains. These results by demonstrating the adverse consequences of an untreated mental health disorder (MDD) on HIV-related outcomes further strengthen the need to urgently act on WHO's call to integrate mental health care in general HIV care.
date: 2018-06-01
date_type: published
official_url: https://doi.org/10.1097/QAI.0000000000001647
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
article_type_text: Article
verified: verified_manual
elements_id: 1574795
doi: 10.1097/QAI.0000000000001647
lyricists_name: Shahmanesh, Maryam
lyricists_id: MSHAH03
actors_name: Sharp, Catherine
actors_id: CLSHA04
actors_role: owner
full_text_status: public
publication: Journal of Acquired Immune Deficiency Syndromes (JAIDS)
volume: 78
number: 2
pagerange: 136-143
issn: 1525-4135
citation:        Kinyanda, E;    Levin, J;    Nakasujja, N;    Birabwa, H;    Nakku, J;    Mpango, R;    Grosskurth, H;                 ... Patel, V; + view all <#>        Kinyanda, E;  Levin, J;  Nakasujja, N;  Birabwa, H;  Nakku, J;  Mpango, R;  Grosskurth, H;  Seedat, S;  Araya, R;  Shahmanesh, M;  Patel, V;   - view fewer <#>    (2018)    Major Depressive Disorder: Longitudinal Analysis of Impact on Clinical and Behavioral Outcomes in Uganda.                   Journal of Acquired Immune Deficiency Syndromes (JAIDS) , 78  (2)   pp. 136-143.    10.1097/QAI.0000000000001647 <https://doi.org/10.1097/QAI.0000000000001647>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10054669/1/00126334-201806010-00002.pdf