Depressive symptoms and its determinants among people living with HIV in Africa: Systematic review and meta-analysis

Background: In Africa, depressive symptoms are prevalent among people living with HIV (PLHIV), significantly impacting their adherence and overall quality of life. The combined burden of HIV and depressive symptoms worsens health outcomes, leading to an increased risk of morbidity and mortality.

Objectives: To estimate the pooled prevalence and identify the associated factors of depressive symptoms among people living with HIV in Africa.

Methods: In this study, we reviewed articles that evaluated the prevalence of depressive symptoms and its contributing variables. The primary studies were searched using the following databases: African Journal Online, Science Direct, EMBASE, Google Scholar, and PubMed. A Microsoft Excel spreadsheet was employed to extract the data, which was then exported to STATA version 14 for further analysis. While publication bias was examined using a funnel plot and Egger’s test, heterogeneity was tested using the I² test.

Results: The estimated pooled prevalence of depressive symptoms among people living with HIV was determined to be 33.32%. Based on the sub-group analysis the higher prevalence of depressive symptoms was found in East Africa, and perinatal women. Furthermore, being female, experiencing stigma, having poor social support, a CD4 count < 200, and comorbid chronic illnesses were significant predictors of depressive symptoms.

Conclusion: This review concluded that one-third of people living with HIV in Africa suffered from depressive symptoms. Additionally, individuals experiencing stigma, poor social support, a CD4 count < 200, and comorbid chronic illnesses, as well as females suffered more from depressive symptoms. Therefore, mental health assessments should address these factors.

• Epidemiology and Determinants of Health
  • Epidemiology
  • Determinants of Health
• Determinants of Health
  • Social support
  • Health services
  • Stigma/discrimination
• Population(s)
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
• Engagement and Care Cascade
  • Treatment
• Mental Health
  • Depression