Depression Symptom Trajectories Among Mothers Living with HIV in Rural Uganda

  • Itziar FamiliarEmail author
  • Alla Sikorskii
  • Sarah Murray
  • Horacio Ruisenor-Escudero
  • Noeline Nakasujja
  • Clinton Korneffel
  • Michael Boivin
  • Judith Bass
Original Paper


The aim was to identify latent class trajectories of depression symptoms among HIV+ women in Uganda. Depression was assessed at four time points using the Hopkins Symptom Checklist among 288 women caring for a child 2–5 years old. Mixture modeling was used to estimate the number and nature of classes defined by trajectories of depressive symptoms over time. Maternal and child characteristics were explored as predictors of class. Three trajectories of symptoms of depression were identified; (1) stable-low, (2) moderate-subclinical, and (3) chronic-high. About 8% of women reported moderately or highly elevated symptoms at the first assessment and consistently onward (i.e. chronically). Higher anxiety levels, less social support, more functionality problems, and more executive behavior problems in children predicted membership in the moderate-subclinical and chronic-high classes. Identifying patterns of depression trajectories can help target intervention efforts for women who are likely to experience the most chronic and impairing symptomatology.


Latent trajectory Women Depression HIV Low- and middle-income countries (LMIC) 


El objetivo de este estudio fue identificar trayectorias de síntomas depresivos en mujeres HIV+ en Uganda. Evaluamos síntomas de depresión en 288 mujeres usando el Hopkins Symptom Checklist en cuatro ocasiones. Utilizando modelaje mixto, describimos el número y tipo de clases definidas por las trayectorias de síntomas depresivos a través del tiempo, así como las características de la mujer y un hijo índice asociadas con cada clase. Se identificaron tres trayectorias: (1) estable-leve, (2) moderada-sub clínica y (3) crónica-elevada. Aproximadamente 8% de las mujeres reportaron síntomas depresivos moderados o elevados en todas las evaluaciones (síntomas crónicos). Mayores niveles de ansiedad, menor apoyo social, mayores problemas de funcionamiento y mayores problemas de conducta ejecutiva en niños se asociaron con las clases moderada-sub clínica o crónica-elevada. Identificar patrones y trayectorias de síntomas depresivos sirve para enfocar intervenciones a individuos con mayor probabilidad de experimentar síntomas crónicos e incapacitantes.

Palabras clave

Trayectorias latentes Mujeres Depresión HIV 



We wish to thank the participants and the Global Health Uganda-Tororo team that made this research possible. This research was supported by NIH Grant R01 HD070723. SM was supported by NIMH of the National Institutes of Health under Award Number T32MH10321.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Itziar Familiar
    • 1
    Email author
  • Alla Sikorskii
    • 2
  • Sarah Murray
    • 3
  • Horacio Ruisenor-Escudero
    • 1
  • Noeline Nakasujja
    • 4
  • Clinton Korneffel
    • 5
  • Michael Boivin
    • 6
  • Judith Bass
    • 2
  1. 1.Department of PsychiatryMichigan State UniversityEast LansingUSA
  2. 2.Departments of Psychiatry and StatisticsMichigan State UniversityEast LansingUSA
  3. 3.Mental Health DepartmentJohns Hopkins University Bloomberg School of Public HealthBaltimoreUSA
  4. 4.Department of Psychiatry, College of Health SciencesMakerere UniversityKampalaUganda
  5. 5.College of Osteopathic MedicineMichigan State UniversityEast LansingUSA
  6. 6.Departments of Psychiatry and NeurologyMichigan State UniversityEast LansingUSA

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