Depression at Treatment Initiation Predicts HIV Antiretroviral Adherence in Uganda.
Depression at Treatment Initiation Predicts HIV Antiretroviral Adherence in Uganda.
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DOI：
10.1177/2325957416677121
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发表时间：
2017
影响因子：
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通讯作者：
Ghosh-Dastidar B
中科院分区：
文献类型：
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作者：
Wagner GJ;Slaughter M;Ghosh-Dastidar B
我们研究了抑郁症（症状类型，诊断严重程度和随时间的变化）和坚持艾滋病毒抗逆转录病毒治疗（ART）的数据从三个纵向研究（N= 1021）的患者开始ART在乌干达之间的关系。使用患者健康问卷（PHQ-9）评估抑郁症状（总分;躯体和认知分量表），并对严重程度进行分类。在基线时，9%的患者患有重度抑郁症，30%的患者患有轻度抑郁症;在第6个月时，82%的患者依从（报告在过去7天内未错过ART给药），在第12个月时为85%。控制人口统计学和医学协变量，多变量随机效应logistic回归模型显示，抑郁症的变化与依从性无关;然而，基线总抑郁症状，特别是认知症状，以及重度和轻度抑郁，是依从性的重要预测因素。这些发现强调了早期识别和积极治疗抑郁症以优化ART依从性的必要性。
We examined the relationship between depression (symptom type, diagnostic severity and change over time) and adherence to HIV antiretroviral therapy (ART) with data from three longitudinal studies (N= 1021) of patients starting ART in Uganda. The Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms (total score; somatic and cognitive subscales), and to categorize severity level. At baseline, 9% had major depression and 30% had minor depression; 82% were adherent (reported no missed ART doses in past 7 days) at Month 6 and 85% at Month 12. Controlling for demographic and medical covariates, multivariate random-effects logistic regression models revealed that change in depression was not related to adherence; however, baseline total depression symptoms, and cognitive symptoms in particular, as well as major and minor depression, were significant predictors of adherence. These findings highlight the need for early identification and aggressive treatment of depression to optimize ART adherence.