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Depressive Symptoms and Their Impact on Health-seeking Behaviors in Newly-diagnosed HIV-infected Patients in Durban, South Africa

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Abstract

We evaluated the prevalence and correlates of depressive symptoms prior to HIV diagnosis and determined the effect of these symptoms on seeking HIV care at an urban and rural clinic in Durban, South Africa. Adults were administered a questionnaire which included the 5-item Mental Health Index (MHI-5) before HIV testing. We determined the depressive symptoms among HIV-infected subjects. Of 1,545 newly-diagnosed HIV-infected subjects, 55% had depressive symptoms by MHI-5 score. Enrolling at the urban clinic and decreasing functional activity score were associated with depressive symptoms. Subjects with depressive symptoms who were referred for HIV testing by a healthcare provider were less likely to obtain a CD4 count than those without depressive symptoms who self-referred for testing. Depressive symptoms were common among newly-diagnosed HIV-infected participants and impacted CD4 uptake. Depression screening at the time of HIV diagnosis is critical for improving linkage to mental health and HIV services in South Africa.

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Acknowledgments

The authors thank the study participants and the dedicated study research assistants at McCord and St. Mary’s Hospitals. This study was supported in part by the Harvard Institute of Global Health, National Institute of Allergy and Infectious Diseases (NIAID) T32 AI 007433; National Institute of Child Health and Human Development (NICHD) T32 HD 055148-02 (L.R.); NIAID K23 AI068458; National Institute of Mental Health (NIMH) R01MH090326; NIAID R01 AI058736; NIAID K24 AI062476; NIMH R01 MH073445; NIAID P30 AI42851 (Harvard Center for AIDS Research), Harvard University Program on AIDS, Claflin Distinguished Scholar Award of the Massachusetts General Hospital (I.V.B.), and the Doris Duke Charitable Foundation, Clinical Scientist Development Award (R.P.W.).

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Authors and Affiliations

  1. Division of Infectious Diseases, Children’s Hospital Boston, 333 Longwood Avenue, Boston, MA, 02139, USA

    Lynn Ramirez-Avila

  2. Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA

    Lynn Ramirez-Avila, Susan Regan, Kenneth A. Freedberg, Rochelle P. Walensky, Elena Losina & Ingrid V. Bassett

  3. Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA

    Lynn Ramirez-Avila, Susan Regan, Kenneth A. Freedberg, Rochelle P. Walensky, Elena Losina & Ingrid V. Bassett

  4. McCord Hospital, Durban, South Africa

    Janet Giddy & Senica Chetty

  5. St. Mary’s Hospital, Mariannhill, Durban, South Africa

    Douglas Ross

  6. Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Jeffrey N. Katz & Elena Losina

  7. Division of Rheumatology, Brigham and Women’s Hospital, Boston, MA, USA

    Jeffrey N. Katz & Elena Losina

  8. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Jeffrey N. Katz

  9. Division of Infectious Disease, Massachusetts General Hospital, Boston, MA, USA

    Rochelle P. Walensky & Ingrid V. Bassett

  10. Center for AIDS Research, Harvard Medical School, Boston, MA, USA

    Kenneth A. Freedberg, Rochelle P. Walensky, Elena Losina & Ingrid V. Bassett

  11. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Kenneth A. Freedberg

  12. Division of Infectious Disease, Brigham and Women’s Hospital, Boston, MA, USA

    Rochelle P. Walensky

  13. Department of Biostatistics, Boston University, Boston, MA, USA

    Elena Losina

Authors
  1. Lynn Ramirez-Avila
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  2. Susan Regan
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  3. Janet Giddy
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  4. Senica Chetty
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  5. Douglas Ross
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  6. Jeffrey N. Katz
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  7. Kenneth A. Freedberg
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  8. Rochelle P. Walensky
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  9. Elena Losina
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  10. Ingrid V. Bassett
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Corresponding author

Correspondence to Lynn Ramirez-Avila.

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Ramirez-Avila, L., Regan, S., Giddy, J. et al. Depressive Symptoms and Their Impact on Health-seeking Behaviors in Newly-diagnosed HIV-infected Patients in Durban, South Africa. AIDS Behav 16, 2226–2235 (2012). https://doi.org/10.1007/s10461-012-0160-y

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  • DOI: https://doi.org/10.1007/s10461-012-0160-y

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