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Depressive Symptoms, the Impact on ART Continuation, and Factors Associated with Symptom Improvement Among a Cohort of People Living with HIV in British Columbia, Canada

AIDS and Behavior (2023)Cite this article

Abstract

Depressive symptoms among people living with HIV (PLWH) are associated with poorer overall health outcomes. We characterized depressive symptoms and improvements in symptomology among PLWH (≥ 19 years old) in British Columbia (BC), Canada. We also examined associations between depressive symptomology and antiretroviral therapy (ART) treatment interruptions. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), within a longitudinal cohort study with three surveys administered 18-months apart. We used multivariable logistic regression to model factors associated with improvements in depressive symptoms (CES-D-10 scores from ≥ 10 to < 10). Of the 566 participants eligible for analysis 273 (48.2%) had CES-D scores indicating significant depressive symptoms (score ≥ 10) at enrollment. Improvements in symptoms at first follow-up were associated with greater HIV self-care on the Continuity of Care Scale (adjusted odds ratio: 1.17; 95% CI 1.03–1.32), and not having a previously reported mental health disorder diagnosis (aOR 2.86; 95% CI 1.01–8.13). Those reporting current cocaine use (aOR 0.33; 95% CI 0.12–0.91) and having a high school education, vs. less than, (aOR 0.25; 95% CI 0.08–0.82) had lower odds of improvement in depressive symptomatology. CES-D scores ≥ 10 were not significantly associated with ART treatment interruptions during follow-up (aOR: 1.08; 95% CI:0.65–1.8). Supporting greater self-care and consideration of mental health management strategies in relation to HIV may be useful in promoting the wellbeing of PLWH who experience depressive symptoms.

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Data Availability

The British Columbia Center for Excellence in HIV/AIDS (BC-CfE) is prohibited from making individual-level data available publicly due to provisions in our service contracts, institutional policy, and ethical requirements. In order to facilitate research, we make such data available via data access requests. Some BC-CfE data is not available externally due to prohibitions in service contracts with our funders or data providers. For more information or to make a request, please contact Mark Helberg, Senior Director, Internal and External Relations, and Strategic Development: mhelberg@bccfe.ca. All data related to this manuscript are provided in the main body of the paper and Supporting Information files.

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Acknowledgements

We would like to thank all those who contributed their time and expertise to this project, including the SHAPE PRAs, co-investigators, collaborators, partner organizations and clinics, as well as the BC-CfE for their ongoing support and guidance. We are particularly grateful to SHAPE participants for sharing their life experiences with us, without whom this work could not be possible. We respectfully acknowledge that our work takes place on ancestral traditional and unceded territories across British Columbia, and we recognize and acknowledge the ongoing harms of colonialism, which contribute to pervasive health equities and disproportionately impact Indigenous people living with HIV. The SHAPE study is funded by the BC Ministry of Health and BC Centre for Excellence in HIV/AIDS. DMM is supported by a Scholar Award from the Michael Smith Foundation for Health Research.

Funding

Funding was provided by the BC Ministry of Health and the BC Centre for Excellence in HIV/AIDS.

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Authors and Affiliations

  1. BC Centre for Excellence in HIV/AIDS, 608 – 1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada

    Tatiana E. Pakhomova, Clara Tam, Lu Wang, Kate Salters, David M. Moore, Justin Barath, Simon Elterman, Nicole Dawydiuk, Tim Wesseling, Sean Grieve, Paul Sereda, Robert Hogg & Rolando Barrios

  2. Simon Fraser University, Burnaby, Canada

    Kate Salters & Robert Hogg

  3. University of British Columbia, Vancouver, Canada

    David M. Moore & Rolando Barrios

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  1. Tatiana E. Pakhomova
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  2. Clara Tam
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Contributions

Each of the listed co-authors contributed substantively to this manuscript. The study was conceived and established by RB and RH. TP drafted the initial manuscript with contributions from CT, KS, DMM, and ND. SG and TW collected data; LW and JB conducted statistical and data analyses. All authors (TP, CT, LW, KS, DMM, JB, ND, SE, TW, SG, PS, RH, RB) contributed substantially to the critical review of the final manuscript.

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Correspondence to Tatiana E. Pakhomova.

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This study was granted ethical approval by the University of British Columbia/Providence Health Care research ethics boards (REB number: H15-01807).

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Pakhomova, T.E., Tam, C., Wang, L. et al. Depressive Symptoms, the Impact on ART Continuation, and Factors Associated with Symptom Improvement Among a Cohort of People Living with HIV in British Columbia, Canada. AIDS Behav (2023). https://doi.org/10.1007/s10461-023-04156-3

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