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Systematic Review of Interventions for Depression for People Living with HIV in Africa

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Abstract

Depression interventions for individuals with HIV/AIDS in Africa are being increasingly evaluated. MEDLINE was searched using key terms: depression, Africa, and HIV, to identify depression interventions for HIV-infected adults in Africa. Perinatal women were excluded. Results were extracted and relative change in depression scores for interventions and net effect calculated. The MEDLINE search yielded 18 articles. Six of seven studies evaluating feasibility were positive, and seven of seven studies evaluating acceptability were also positive. Three studies investigated the effect of psychotherapy (% relative decrease of depressive symptoms for intervention: %net decrease compared to controls) (73%:39% decrease). Four studies investigated task-shifting of psychotherapy (47%:34% decrease). Three studies evaluated antidepressants (79%:39% decrease). Three studies investigated task-shifting of antidepressant treatment (82%:65% decrease). An exercise intervention was evaluated (66%:49% decrease). One trial investigated minocycline with non-statistically significant results. Finally, three studies investigated other psychosocial interventions (44%:21% decrease). Overall, the results highlight the need for large, randomized trials to establish efficacy as well as implementation studies.

Resumen

Las intervenciones contra depresión para personas con VIH/SIDA en África se están evaluando de forma cada vez más frecuente. Se realizo una busqueda en MEDLINE usando los términos: depresión, África y VIH, para identificar intervenciones contra depresión para adultos infectados por el VIH en África. Se excluyeron las mujeres en estado perinatal. Se extrajeron los resultados y se calculó el cambio relativo en las escalas de depresión para las intervenciones y el efecto neto. La búsqueda en MEDLINE produjo 18 artículos. Seis de los siete estudios que evaluaron la factibilidad fueron positivos y siete de los siete estudios positivos que evaluaron la aceptabilidad. Tres estudios investigaron el efecto de la psicoterapia (% de disminución relativa de la intervención: % de disminución neta en comparación con los controles) (73%:39%). Cuatro estudios investigaron el cambio de tareas de la psicoterapia (47%:34%). Tres estudios evaluaron medicamentos antidepresivos (79%:39%). Tres estudios investigaron el cambio de tareas del tratamiento antidepresivo (82%:65%). Se evaluó una intervención de ejercicio (66%:49%). Un ensayo investigó minociclina con resultados no estadísticamente significativos. Por último, tres estudios investigaron otras intervenciones psicosociales (44%:21%). En general, los resultados enfatizan la necesidad de estudios prospectivos y randomizados para establecer elementos tanto de eficacia, como de implementacion.

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Acknowledgements

This research was supported by the National Institute of Neurologic Diseases and Stroke (NINDS) and Fogarty International Center (R01NS086312, R25TW009345), National Institute of Allergy and Infectious Diseases (U01AI089244, T32AI055433). The authors would like to thank Jose Debes, MD, MS for his assistance in translating our abstract into Spanish.

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Authors and Affiliations

  1. Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, 420 Delaware Street, SE, MMC 250, Minneapolis, MN, 55455, USA

    Sarah M. Lofgren & David R. Boulware

  2. Infectious Disease Institute, P.O. Box 22418, Kampala, Kampala, Uganda

    Sarah M. Lofgren & Noeline Nakasujja

  3. Department of Psychiatry, Makerere University College of Health Sciences, Mulago Hill Complex, Kampala, Uganda

    Noeline Nakasujja

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  1. Sarah M. Lofgren
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Correspondence to Sarah M. Lofgren.

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This article does not contain any studies with human participants performed by any of the authors.

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Lofgren, S.M., Nakasujja, N. & Boulware, D.R. Systematic Review of Interventions for Depression for People Living with HIV in Africa. AIDS Behav 22, 1–8 (2018). https://doi.org/10.1007/s10461-017-1906-3

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