Risk Factors for Depression Among Middle-Aged to Older People Living With HIV in Lima, Peru

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Abstract

Introduction

Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.

Materials and Methods

We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses.

Results

Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]).

Discussion

Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.

Plain Language Summary

Factors affecting depression in older people with HIV in Peru

Introduction

Depression is common in older people living with HIV (PLWH) worldwide. We identified depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.

Materials and Methods

We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered.

Results

Discussion

Related collections

Most cited references 40

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Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms.

Rachel H Salk, Janet Hyde, Lyn Y. Abramson (2017)

In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record

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Prevalence of Depression in the Community from 30 Countries between 1994 and 2014

Grace Y. Lim, Wilson W. S. Tam, Yanxia Lu … (2018)

The prevalence of depression may be affected by changes in psychiatric practices and the availability of online mental health information in the past two decades. This study aimed to evaluate the aggregate prevalence of depression in communities from different countries between 1994 and 2014 and to explore the variations in prevalence stratified by geographical, methodological and socio-economic factors. A total of 90 studies were identified and met the inclusion criteria (n = 1,112,573 adults) with 68 studies on single point prevalence, 9 studies on one-year prevalence, and 13 studies on lifetime prevalence of depression. A random-effects model meta-analysis that was performed to calculate the aggregate point, one-year and lifetime prevalence of depression calculated prevalences of 12.9%, 7.2% and 10.8% respectively. Point prevalence of depression was significantly higher in women (14.4%), countries with a medium human development index (HDI) (29.2%), studies published from 2004 to 2014 (15.4%) and when using self-reporting instruments (17.3%) to assess depression. Heterogeneity was identified by meta-regression and subgroup analysis, and response rate, percentage of women and year of publication, respectively, were determined contribute to depression prevalence. This meta-analysis allows benchmarking of the prevalence of depression during the era when online health information emerged, facilitating future comparisons.

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HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors

Robert K. Heaton, Donald R Franklin, Ronald Ellis … (2010)

Combination antiretroviral therapy (CART) has greatly reduced medical morbidity and mortality with HIV infection, but high rates of HIV-associated neurocognitive disorders (HAND) continue to be reported. Because large HIV-infected (HIV+) and uninfected (HIV−) groups have not been studied with similar methods in the pre-CART and CART eras, it is unclear whether CART has changed the prevalence, nature, and clinical correlates of HAND. We used comparable methods of subject screening and assessments to classify neurocognitive impairment (NCI) in large groups of HIV + and HIV − participants from the pre-CART era (1988–1995; N = 857) and CART era (2000–2007; N = 937). Impairment rate increased with successive disease stages (CDC stages A, B, and C) in both eras: 25%, 42%, and 52% in pre-CART era and 36%, 40%, and 45% in CART era. In the medically asymptomatic stage (CDC-A), NCI was significantly more common in the CART era. Low nadir CD4 predicted NCI in both eras, whereas degree of current immunosuppression, estimated duration of infection, and viral suppression in CSF (on treatment) were related to impairment only pre-CART. Pattern of NCI also differed: pre-CART had more impairment in motor skills, cognitive speed, and verbal fluency, whereas CART era involved more memory (learning) and executive function impairment. High rates of mild NCI persist at all stages of HIV infection, despite improved viral suppression and immune reconstitution with CART. The consistent association of NCI with nadir CD4 across eras suggests that earlier treatment to prevent severe immunosuppression may also help prevent HAND. Clinical trials targeting HAND prevention should specifically examine timing of ART initiation.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Assoc Provid AIDS Care

Journal ID (iso-abbrev): J Int Assoc Provid AIDS Care

Journal ID (publisher-id): JIA

Journal ID (hwp): spjia

Title: Journal of the International Association of Providers of AIDS Care

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 2325-9574

ISSN (Electronic): 2325-9582

Publication date (Electronic): 14 August 2024

Publication date Collection: Jan-Dec 2024

Volume: 23

Electronic Location Identifier: 23259582241273452

Affiliations

[1 ]Department of Epidemiology, Ringgold 33225, universityUniversidad San Ignacio de Loyola; , Lima, Peru

[2 ]Department of Neurology, Ringgold 12244, universityNorthwestern University School of Medicine; , Chicago, IL, USA

[3 ]School of Public Health, Ringgold 33216, universityUniversidad Peruana Cayetano Heredia; , Lima, Peru

[4 ]Ringgold 2572, universityMississippi College; , Clinton, MS, USA

[5 ]Via Libre, Lima, Peru

[6 ]Department of Neurology, Ringgold 6797, universityUniversity of North Carolina at Chapel Hill School of Medicine; , Chapel Hill, NC, USA

Author notes

[*]Monica M Diaz, Department of Neurology, University of North Carolina at Chapel Hill School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC 27599, USA. Email: Monica.diaz@ 123456neurology.unc.edu

Author information

Monica M Diaz https://orcid.org/0000-0001-9663-5948

Article

Publisher ID: 10.1177_23259582241273452

DOI: 10.1177/23259582241273452

PMC ID: 11325335

PubMed ID: 39140382

SO-VID: 69c27898-326c-4d4f-8d13-e24d8743f942

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 9 April 2024

Date revision received : 9 June 2024

Date accepted : 15 July 2024

Funding

Funded by: Fogarty International Center, FundRef https://doi.org/10.13039/100000061;

Award ID: D43TW009343

Custom metadata

typesetter ts19

cover-date January-December 2024

Keywords: depression,people living with hiv,peru,latin america,risk factors,patient health questionnaire-9

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Keywords: depression, people living with hiv, peru, latin america, risk factors, patient health questionnaire-9

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Risk Factors for Depression Among Middle-Aged to Older People Living With HIV in Lima, Peru

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Abstract

Introduction

Materials and Methods

Results

Discussion

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Introduction

Materials and Methods

Results

Discussion

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SciELO Peru

Most cited references 40

Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms.

Prevalence of Depression in the Community from 30 Countries between 1994 and 2014

HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors

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