ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Depression and Anxiety as Risk Factors for Delayed Care-Seeking Behavior in Human Immunodeficiency Virus-Infected Individuals in South Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and trends of advanced HIV disease among antiretroviral therapy-naïve and antiretroviral therapy-experienced patients in South Africa between 2010-2021: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV.Current HIV/AIDS reports · 2021Pooled it
- Integrating depression management into HIV primary care in central Malawi: the implementation of a pilot capacity building program.BMC health services research · 2018Trial
- Evaluation of a Clinic-Level Intervention to Increase Anxiety and Depression Screening in an Urban HIV Clinic.AIDS and behavior · 2026Article
- Cost-Effectiveness of Reducing HIV Infections Through Screening and Treating Alcohol Use and Depression in KwaZulu-Natal, South Africa: A Mathematical Modeling Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Cost-Effectiveness and Impact of Depression Treatment Implementation on HIV Outcomes in Western Kenya: A Mathematical Modelling Study.Journal of the International AIDS Society · 2026Article
- How has mental health impacted the HIV epidemic and how has the HIV epidemic impacted mental health in Western Kenya? A mathematical modelling study.BMJ global health · 2026Article
- Establishing an empirical cut-off on the 12-item Brief Berger HIV Stigma Scale to screen psychosocial vulnerability among PLHIV in Nigeria.PLOS global public health · 2026Article
- An assessment of anxiety and depression among HIV-positive pregnant women in a tertiary hospital located in southeast Nigeria: a cross-sectional comparative analysis.Frontiers in psychiatry · 2026Article
- Article
- Depression and anxiety among people living with HIV and key populations at risk for HIV in the Eastern European and Central Asian region: a scoping review.BMJ public health · 2025Article
- Beyond the Physical: The Mental Health Toll of Delayed Blood Work in Global Health Disparities.International journal of public health · 2025Article
- Psychosocial and behavioral factors associated with HIV among adolescent girls and young women in DREAMS districts in South Africa: cross-sectional survey.Frontiers in public health · 2025Article
- Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2025Article
- Article
- Prevalence and co-occurrence of symptoms of mental and substance use disorders among people with HIV age 40 and older in low- and middle-income countries: a cross-sectional study.Journal of the International AIDS Society · 2024Article
- Optimizing generalized anxiety disorder screening in young adults perinatally affected by HIV: A psychometric analysis.Journal of mood and anxiety disorders · 2024Article
- Patient Perspectives on Portal-Based Anxiety and Depression Screening in HIV Care: A Qualitative Study Using the Consolidated Framework for Implementation Research.International journal of environmental research and public health · 2024Article
- Article
- "I've accepted it because at the end of the day there is nothing, I can do about it": A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa.PLOS global public health · 2024Article
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Authors and funding
7 authors.
Funding
Abstract
Background: Facility- and community-based efforts to improve human immunodeficiency virus (HIV) testing in sub-Saharan Africa may benefit from understanding how mental health influences HIV care-seeking behavior. Methods: We conducted a study among adults presenting for HIV testing in the Umlazi township of South Africa. Prior to testing, we measured depression using the 9-item Patient Health Questionnaire and anxiety using the 7-item Generalized Anxiety Disorder scale. We categorized patients as delayed presenters (presenting to clinic >3 months after first HIV-positive test), late testers (presenting within 3 months of diagnosis with a CD4 count ≤200 cells per µL), or neither. We used multinomial logistic regression adjusting for sociodemographic and behavioral characteristics to determine the effects of depression and anxiety on HIV care-seeking behavior. Results: Among 1482 HIV-infected adults, 59% were female and mean age was 33 years. The prevalence of depression in the cohort was 33% and anxiety was 9%. In adjusted models, mild to moderate depression was not associated with delayed presentation or late testing. HIV-infected adults with severe depression had 3.6 greater odds (95% confidence interval [CI], 1.2-10.2) of delayed presentation and 2.2 greater odds (95% CI, 1.01-4.8) of late testing compared with those without depression. Individuals with generalized anxiety had 2.3 greater odds (95% CI, 1.3-4.2) of delayed presentation compared with those without anxiety. Conclusions: Severe depression was associated with delayed presentation and late testing, while anxiety was associated only with delayed presentation. Screening for mental health services may improve antiretroviral therapy initiation and linkage to care following HIV testing.
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