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.

Objectives: This scoping review aimed to map the literature on depression and anxiety among people living with HIV and key populations in the Eastern European and Central Asian (EECA) region. The review assessed the burden of these disorders, identified inconsistencies in measurement approaches and highlighted gaps to inform future research and policy efforts. Design: A scoping review was conducted using Arksey and O'Malley's framework, involving a systematic search, screening and synthesis of published and grey literature in EECA Data sources: a comprehensive search was performed across five databases (CINAHL, PubMed, MEDLINE, Web of Science and PsycINFO) between July 2023 and February 2024. Additional sources were identified through Google Scholar and hand searches of reference lists from relevant research groups. Eligibility criteria: Original research articles published between January 2013 and July 2023, involving participants aged 16 years or older and reporting data from one or more EECA countries were included. Eligible studies were in English, Georgian or Russian. Excluded were reviews, editorials, treatment outcome studies, pooled data from other regions, conference materials and dissertations. Data extraction and synthesis: Data extraction was performed independently by team members using a Covidence template. Studies were categorised based on target populations, measurement approaches and reported prevalence of depression and anxiety. Narrative synthesis was conducted due to the heterogeneity of study designs and outcomes. Results: Of 3514 articles identified, 58 met inclusion criteria. Depression prevalence ranged from 8.5% to 88.0% and anxiety from 3.0% to 74.0%. Depression was assessed using 15 different scales, while anxiety was measured with eight tools. Reported prevalence exceeded global estimates, highlighting the need for targeted interventions. Conclusion: The review highlights the burden of depression and anxiety in EECA, variability in measurement approaches and a lack of longitudinal and implementation research. Future efforts should standardise measurement tools, develop cohort studies and address implementation barriers to improve mental health and HIV outcomes in the region.