Prevalence of depression in people living with HIV and AIDS at the Kalafong Provincial Tertiary Hospital Antiretroviral Clinic

BACKGROUND: Compared to the general population, there is an increased prevalence of depression in people living with HIV and AIDS (PLWHA). The combination of these two common illnesses has profound consequences on the patient and on the healthcare system. OBJECTIVE: This study determined the prevalence of depressive symptomatology in PLWHA attending the Kalafong Hospital ARV Clinic. The study also established if the patients received definitive treatment for unipolar depression. METHODS: A cross-sectional, descriptive study was carried out on 622 adult patients, aged 18 years or older. A brief rating scale for depression, the Centre for Epidemiological Study Depression Scale (CES-D) was administered to participants. The CES-D is a 20-item self-rating scale that assesses current levels of depression as per DSM-IV criteria. The traditional score of 16 and above was used to define a case of depression. RESULTS: The prevalence of depression according to CES-D scale was 53.8%. The study found that none of the 622 patients ever received definitive treatment for depression. A lower CD4 count is associated with more depressive symptomatology, most significantly in patients with a CD4 count of 50 or less. CONCLUSIONS: Depressive symptomatology was highly prevalent in the study patients. Despite the high prevalence, none of the study sample patients were treated for clinical depression. The findings reflect the importance of evaluating for depression in PLWHA, especially in high-risk groups such as patients presenting for their initiation visit or patients with a CD4 count of 50 or less. Depression remains under-recognised and under-treated in PLWHA.