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Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa

Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa
Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa
We assess depression rates and investigate whether depression among HIV-infected adults receiving antiretroviral treatment (ART) is associated with social support and HIV coping strategies in rural South Africa (SA). The study took place in a decentralised public-sector ART programme in a poor, rural area of KwaZulu-Natal, SA, with high-HIV prevalence and high-ART coverage. The 12-item General Health Questionnaire (GHQ12), validated in this setting, was used to assess depression in 272 adults recently initiated on ART. Estimates of depression prevalence ranged from 33% to 38%, depending on the method used to score the GHQ12. Instrumental social support (providing tangible factors for support, such as financial assistance, material goods or services), but not emotional social support (expressing feelings, such as empathy, love, trust or acceptance, to support a person), was significantly associated with lower likelihood of depression [adjusted odds ratio (aOR) = 0.65, 95% confidence interval (CI) 0.52–0.81, P < 0.001], when controlling for sex, age, marital status, education, household wealth and CD4 cell count. In addition, using “avoidance of people” as a strategy to cope with HIV was associated with an almost three times higher odds of depression (aOR = 2.79, CI: 1.34–5.82, P = 0.006), whereas none of the other five coping strategies we assessed was significantly associated with depression. In addition to antidepressant drug treatment, interventions enhancing instrumental social support and behavioural therapy replacing withdrawal behaviours with active HIV coping strategies may be effective in reducing the burden of depression among patients on ART.
depression, HIV/AIDS, antiretroviral treatment, social support, coping strategies
0954-0121
1-8
Yeji, Francis
dbfe4367-1386-4496-8b6e-f99eff8fb973
Klipstein-Grobusch, Kerstin
86cfe72b-5bfc-43e1-8452-a0797ee4bbca
Newell, Marie-Louise
87caf679-14d9-405d-b5b3-e00ae33728e3
Hirschhorn, Lisa R
8361164a-9e35-44ea-bf94-2219e79e06f0
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Bärnighausen, Till
337d5ec4-e26e-40de-aa26-42e5c5c9b61e
Yeji, Francis
dbfe4367-1386-4496-8b6e-f99eff8fb973
Klipstein-Grobusch, Kerstin
86cfe72b-5bfc-43e1-8452-a0797ee4bbca
Newell, Marie-Louise
87caf679-14d9-405d-b5b3-e00ae33728e3
Hirschhorn, Lisa R
8361164a-9e35-44ea-bf94-2219e79e06f0
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Bärnighausen, Till
337d5ec4-e26e-40de-aa26-42e5c5c9b61e

Yeji, Francis, Klipstein-Grobusch, Kerstin, Newell, Marie-Louise, Hirschhorn, Lisa R, Hosegood, Victoria and Bärnighausen, Till (2014) Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa. AIDS Care, 1-8. (doi:10.1080/09540121.2014.931561).

Record type: Article

Abstract

We assess depression rates and investigate whether depression among HIV-infected adults receiving antiretroviral treatment (ART) is associated with social support and HIV coping strategies in rural South Africa (SA). The study took place in a decentralised public-sector ART programme in a poor, rural area of KwaZulu-Natal, SA, with high-HIV prevalence and high-ART coverage. The 12-item General Health Questionnaire (GHQ12), validated in this setting, was used to assess depression in 272 adults recently initiated on ART. Estimates of depression prevalence ranged from 33% to 38%, depending on the method used to score the GHQ12. Instrumental social support (providing tangible factors for support, such as financial assistance, material goods or services), but not emotional social support (expressing feelings, such as empathy, love, trust or acceptance, to support a person), was significantly associated with lower likelihood of depression [adjusted odds ratio (aOR) = 0.65, 95% confidence interval (CI) 0.52–0.81, P < 0.001], when controlling for sex, age, marital status, education, household wealth and CD4 cell count. In addition, using “avoidance of people” as a strategy to cope with HIV was associated with an almost three times higher odds of depression (aOR = 2.79, CI: 1.34–5.82, P = 0.006), whereas none of the other five coping strategies we assessed was significantly associated with depression. In addition to antidepressant drug treatment, interventions enhancing instrumental social support and behavioural therapy replacing withdrawal behaviours with active HIV coping strategies may be effective in reducing the burden of depression among patients on ART.

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More information

Published date: 3 July 2014
Keywords: depression, HIV/AIDS, antiretroviral treatment, social support, coping strategies
Organisations: Social Sciences

Identifiers

Local EPrints ID: 367358
URI: http://eprints.soton.ac.uk/id/eprint/367358
ISSN: 0954-0121
PURE UUID: c266859d-091c-4f2e-a504-a502587be78d
ORCID for Victoria Hosegood: ORCID iD orcid.org/0000-0002-2244-2518

Catalogue record

Date deposited: 28 Jul 2014 15:04
Last modified: 09 Nov 2021 03:23

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Contributors

Author: Francis Yeji
Author: Kerstin Klipstein-Grobusch
Author: Marie-Louise Newell
Author: Lisa R Hirschhorn
Author: Till Bärnighausen

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