ArticleEClinicalMedicine2021
Depression and anxiety as barriers to art initiation, retention in care, and treatment outcomes in KwaZulu-Natal, South Africa.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Disparities in Awareness, Willingness and Uptake of Biomedical HIV Prevention Among Bisexual and Gay Men: A Systematic Review and Meta-Analysis.Journal of the International AIDS Society · 2026Pooled it
- Siyakhana: A hybrid type 2 effectiveness-implementation stepped-wedge trial to reduce stigma towards substance use and depression among community health workers in HIV/TB care in South Africa.Journal of substance use and addiction treatment · 2025Trial
- Psychosocial vulnerabilities and loss to follow-up in people living with HIV in France.HIV medicine · 2026Article
- Effectiveness of Friendship Bench in Alleviating Anxiety and Depression Symptoms Among People Living with HIV and High-Risk Populations: A Systematic Review and Meta-analysis.AIDS and behavior · 2026Review
- Thoughts of Death or Self-injury, Non-same-day ART Initiation, and 2-year Incidence of Disengagement from Care Among People Entering HIV Care in Cameroon.AIDS and behavior · 2026Article
- Exploring determinants of quality of life for virally suppressed people with HIV in Northern Taiwan.BMC infectious diseases · 2026Article
- Challenges and Enablers of Antiretroviral Therapy Adherence Among Ethiopian Adolescents: A Qualitative Study.International journal of sexual health : official journal of the World Association for Sexual Health · 2026Article
- Gender, mental health symptoms, loss to clinic, and viral non-suppression 6 months after HIV care initiation among a cohort of people with HIV in Cameroon.BMC public health · 2025Article
- Exploring the influence of age, gender, stigma, and years living with HIV on mental health outcomes.HIV medicine · 2025Article
- Immunological and Neurological Signatures of the Co-Infection of HIV and HTLV: Current Insights and Future Perspectives.Viruses · 2025Review
- Article
- Hospitalized with HIV in Zambia: individual and system factors driving the high burden of admissions and post-discharge mortality in the era of HIV epidemic control.AIDS research and therapy · 2025Article
- 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
- Depression and the revolving door of HIV care: using multistate approaches to understand complex longitudinal exposure/outcome relationships among a cohort of people entering HIV care in Cameroon from 2019 to 2020.BMJ public health · 2025Article
- Article
- Community health worker training to reduce mental health and substance use stigma towards patients who have disengaged from HIV/TB care in South Africa: protocol for a stepped wedge hybrid type II pilot implementation trial.Implementation science communications · 2024Article
- Depression and its associated factors among people living with HIV in the Volta region of Ghana.PLOS mental health · 2024Article
- Interaction of social support and depressive symptoms on antiretroviral therapy adherence among people living with HIV in South Africa.Health SA = SA Gesondheid · 2024Article
- Correlates of Depression in ART Adherence among Youths in Lilongwe, Malawi.Tropical medicine and infectious disease · 2023Article
- The Economic Burden of Chronic Diseases with Co-Occurring Depression and Alcohol Use Disorder for People in the Western Cape, South Africa.SSM. Mental health · 2023Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundSince mental health may influence HIV care among people living with HIV (PLHIV), we sought to evaluate the impact of anxiety and depression on ART initiation and HIV-related outcomes.
methodsWe conducted a prospective cohort study of PLHIV in the Umlazi Township of KwaZulu-Natal, South Africa. We measured depression using the Patient Health Questionnaire (PHQ-9) and anxiety using the Generalized Anxiety Disorder (GAD-7) scale, both of which have been validated in sub-Saharan Africa, among all patients prior to receiving a positive HIV test. We then followed those who tested HIV+ for 12 months to determine their time to ART initiation, missing clinic visits or refills, retention in care, hospitalization, and death. We used logistic regression models, adjusted for socio-demographic characteristics such as age and sex, to examine the effects of baseline measures of depression and anxiety on ART initiation and HIV treatment outcomes.
findingsAmong 2,319 adult PLHIV, mean age was 33 years (SD=9.3 years), 57% were female, and baseline median CD4 count was 317 cells/mm INTERPRETATIONS: The presence of depression is a significant barrier to ART initiation and retention in care among adult PLHIV in South Africa. Mental health screenings around the time of HIV testing may help improve linkage and HIV-related outcomes.
fundingThis work was supported by the Infectious Disease Society of America Education & Research Foundation and National Foundation for Infectious Diseases (PKD); Massachusetts General Hospital Executive Committee on Research (PKD); the Harvard University Center for AIDS Research [AI060354] (PKD); and the National Institute of Allergy and Infectious Diseases [AI108293, AI143351] (PKD). The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health or other funding agencies.
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