Treating depression in HIV/AIDS

Abstract

The prevalence of HIV/AIDS has reached alarming proportions in South Africa. Although it is strongly associated with depressive moods, there are very few published studies on its treatment in patients with HIV/AIDS. This article reviews the prevalence, treatment and potential effects of depressive disorders on immunity and adherence to antiretroviral therapy (ART).The studied prevalence of depressive disorders in HIV-positive patients varies widely, ranging from 0% to 47.8%. However, these patients have nearly twice the likelihood of having had a recent episode of major depressive disorder compared with HIV-negative individuals.

Currently available antidepressant medications are equally effective in treating HIV/AIDS patients and the general population. Furthermore, intervention studies have shown that psychotherapy reduces depressive symptoms and is well tolerated. Interpersonal psychotherapy is more successful than supportive psychotherapy in lessening depression, and patients experience improved functioning physically and emotionally.

Untreated depression may be associated with reduced adherence to ART, immunosuppression, and more rapid HIV illness progression. In South Africa, HIV/AIDS patients may be at greater risk for psychiatric disorder given the potentially stressful living conditions including high rates of unemployment and poverty, poor and unstable housing, inadequate social services, and high rates of crime and domestic violence. A lack of data on depression in South Africa underscores the need for further research.