Associations Between Antiretroviral Therapy-related Experiences and Mental Health Status Among People Living with HIV in China: a Prospective Observational Cohort Study

Overview

Journal AIDS Res Ther

Publisher Biomed Central

Specialty Infectious Diseases

Date 2021 Sep 10

PMID 34503529

Citations 4

Authors

Jinzhao Xie

Zixin Wang

Quanmin Li

Qiangsheng He

Guohong Xu

Yonghong Li

Kai Zhou

Linghua Li

Jing Gu

Affiliations

Soon will be listed here.

Abstract

Background: Mental health problems (e.g., depression and anxiety) are among the most commonly reported comorbidities of HIV. Antiretroviral therapy (ART) coverage has increased sharply. The purposes of this prospective cohort study were to investigate the ART-related experiences and whether they were associated with mental health problems among a sample of people living with HIV undergoing ART in China.

Methods: The participants were 400 people living with HIV who had started ART for the first time in Guangzhou city. They were followed-up 1-year after ART initiation. Probable depression and moderate/severe anxiety were measured at baseline and Month 12, while experiences related to ART (e.g., side effects and regained self-confidence) were measured at Month 6. Univariate and multivariate logistic regressions were used to explore the associations between baseline characteristics, ART-related experiences and mental health status.

Results: Among the 300 participants (75.0%) who completed all three surveys, a significant decline in prevalence of probable depression (23.0% at baseline vs. 14.0% at Month 12, P = 0.002) and moderate/severe anxiety (14.7% at baseline vs. 8.7% at Month 12, P = 0.023) was observed during the follow-up period. After adjustment for mental health status and potential confounders at baseline, a number of ART-related experiences at Month 6 were associated with probable depression and/or moderate/severe anxiety measured at Month 12. Improved physical health, relationships with sexual partners, and self-confidence were associated with decreased mental health issues, while the side effects of ART, AIDS-related symptoms, and inconvenience in daily life due to ART use were associated with increased mental health issues.

Conclusions: ART-related experiences were associated with mental health problems, tailored mental health promotion interventions targeting these experiences are needed.

Citing Articles

Prevalence of Depression Among People Living with HIV on Antiretroviral Therapy in Africa: A Systematic Review and Meta-Analysis.

Molapo D, Mokgalaboni K, Phoswa W Healthcare (Basel). 2025; 13(1.

PMID: 39791692 PMC: 11719924. DOI: 10.3390/healthcare13010085.

The relationship between social support and depression among HIV-positive men who have sex with men in China: the chain mediating role of psychological flexibility and hope.

Wang R, Zheng F, Cao G, Goldsamt L, Shen Y, Zhang C Front Public Health. 2023; 11:1271915.

PMID: 38026353 PMC: 10665023. DOI: 10.3389/fpubh.2023.1271915.

Perceptions toward antiretroviral therapy and delayed ART initiation among people living with HIV in Changsha, China: mediating effects of treatment willingness.

Zhou Y, Li Y, Xiao X, Qian H, Wang H Front Public Health. 2023; 11:1105208.

PMID: 37383264 PMC: 10294673. DOI: 10.3389/fpubh.2023.1105208.

Depression-Mediating Pathways From Household Adversity to Antiretroviral Therapy Nonadherence Among Children and Adolescents Living With HIV in Zambia: A Structural Equation Modeling Approach.

Rosen J, Mbizvo M, Phiri L, Chibuye M, Namukonda E, Kayeyi N J Acquir Immune Defic Syndr. 2023; 93(3):191-198.

PMID: 36976552 PMC: 10272024. DOI: 10.1097/QAI.0000000000003193.

Relationships Among Trajectories of Sleep Disturbance, Depression, and Antiretroviral Therapy in Persons Newly Diagnosed with HIV: A One-and-a-Half-Year Observational Longitudinal Study.

Chen C, Liu H, Chen Y, Ko N Nat Sci Sleep. 2022; 14:2133-2142.

PMID: 36483983 PMC: 9724576. DOI: 10.2147/NSS.S377464.

References

Li J, Mo P, Wu A, Lau J . Roles of Self-Stigma, Social Support, and Positive and Negative Affects as Determinants of Depressive Symptoms Among HIV Infected Men who have Sex with Men in China. AIDS Behav. 2016; 21(1):261-273. PMC: 4992470. DOI: 10.1007/s10461-016-1321-1. View

Li T, Tubiana R, Katlama C, Calvez V, Ait Mohand H, Autran B . Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease. Lancet. 1998; 351(9117):1682-6. DOI: 10.1016/s0140-6736(97)10291-4. View

Chen W, Shiu C, Yang J, Simoni J, Fredriksen-Goldsen K, Lee T . Antiretroviral Therapy (ART) Side Effect Impacted on Quality of Life, and Depressive Symptomatology: A Mixed-Method Study. J AIDS Clin Res. 2013; 4:218. PMC: 3786003. DOI: 10.4172/2155-6113.1000218. View

Nachega J, Mutamba B, Basangwa D, Nguyen H, Dowdy D, Mills E . Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults. Trop Med Int Health. 2012; 18(1):53-7. DOI: 10.1111/tmi.12019. View

Wang T, Fu H, Kaminga A, Li Z, Guo G, Chen L . Prevalence of depression or depressive symptoms among people living with HIV/AIDS in China: a systematic review and meta-analysis. BMC Psychiatry. 2018; 18(1):160. PMC: 5984474. DOI: 10.1186/s12888-018-1741-8. View

Rong H, Nianhua X, Jun X, Lianguo R, Si W, Sheng W . Prevalence of and risk factors for depressive symptoms among people living with HIV/AIDS receiving antiretroviral treatment in Wuhan, China: a short report. AIDS Care. 2017; 29(12):1524-1528. DOI: 10.1080/09540121.2017.1327649. View

. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Lancet HIV. 2019; 6(12):e831-e859. PMC: 6934077. DOI: 10.1016/S2352-3018(19)30196-1. View

Lowther K, Selman L, Harding R, Higginson I . Experience of persistent psychological symptoms and perceived stigma among people with HIV on antiretroviral therapy (ART): a systematic review. Int J Nurs Stud. 2014; 51(8):1171-89. DOI: 10.1016/j.ijnurstu.2014.01.015. View

McMahon J, Braksmajer A, Zhang C, Leblanc N, Chen M, Aidala A . Syndemic factors associated with adherence to antiretroviral therapy among HIV-positive adult heterosexual men. AIDS Res Ther. 2019; 16(1):32. PMC: 6842154. DOI: 10.1186/s12981-019-0248-9. View

10.

Asangbeh S, Sobngwi J, Ekali G, Eyoum C, Msellati P . Predictors of depression among patients on art in a rural health district in North West Cameroon. AIDS Care. 2015; 28(2):205-8. DOI: 10.1080/09540121.2015.1074654. View

11.

Gebrezgiabher B, Abraha T, Hailu E, Siyum H, Mebrahtu G, Gidey B . Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study. Depress Res Treat. 2019; 2019:3250431. PMC: 6378035. DOI: 10.1155/2019/3250431. View

12.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

13.

Han J, Jia P, Huang Y, Gao B, Yu B, Yang S . Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS). BMC Public Health. 2020; 20(1):581. PMC: 7189431. DOI: 10.1186/s12889-020-08705-6. View

14.

Liu H, Zhao M, Ren J, Qi X, Sun H, Qu L . Identifying factors associated with depression among men living with HIV/AIDS and undergoing antiretroviral therapy: a cross-sectional study in Heilongjiang, China. Health Qual Life Outcomes. 2018; 16(1):190. PMC: 6146526. DOI: 10.1186/s12955-018-1020-x. View

15.

Krumme A, Kaigamba F, Binagwaho A, Murray M, Rich M, Franke M . Depression, adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy. J Epidemiol Community Health. 2014; 69(3):284-9. DOI: 10.1136/jech-2014-204494. View

16.

Kim M, Kim S, Chang H, Kim Y, Jin S, Jung H . Comparison of Antiretroviral Regimens: Adverse Effects and Tolerability Failure that Cause Regimen Switching. Infect Chemother. 2016; 47(4):231-8. PMC: 4716274. DOI: 10.3947/ic.2015.47.4.231. View

17.

Gakhar H, Kamali A, Holodniy M . Health-related quality of life assessment after antiretroviral therapy: a review of the literature. Drugs. 2013; 73(7):651-72. PMC: 4448913. DOI: 10.1007/s40265-013-0040-4. View

18.

Liu H, Xu Y, Sun Y, Dumenci L . Measuring HIV stigma at the family level: psychometric assessment of the Chinese Courtesy Stigma Scales (CCSSs). PLoS One. 2014; 9(3):e92855. PMC: 3962465. DOI: 10.1371/journal.pone.0092855. View

19.

Manne-Goehler J, Kakuhikire B, Abaasabyoona S, Barnighausen T, Okello S, Tsai A . Depressive Symptoms Before and After Antiretroviral Therapy Initiation Among Older-Aged Individuals in Rural Uganda. AIDS Behav. 2018; 23(3):564-571. PMC: 6719297. DOI: 10.1007/s10461-018-2273-4. View

20.

Leserman J . Role of depression, stress, and trauma in HIV disease progression. Psychosom Med. 2008; 70(5):539-45. DOI: 10.1097/PSY.0b013e3181777a5f. View