Factors associated with depression among women living with HIV in Bangui, Central African Republic
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254012Keywords:
Depressive disorders, Bangui, Central African Republic, HIVAbstract
Background: Depressive disorders significantly affect the well-being and quality of life of people living with HIV, particularly women. This study investigated the extent of mental health issues among women living with HIV in Bangui and analyzes associated factors.
Methods: A cross-sectional analytical study was conducted from January 1 to November 30, 2024, involving HIV-positive women at the National Reference Center for Sexually Transmitted Infections and Antiretroviral Therapy in Bangui. Depression was assessed using the Beck Depression Inventory and a second questionnaire was used to assess the determinants of mental health. Univariate and multivariate analyses identified factors associated with depression, while controlling for potential confounding effects.
Results: A total of 570 women living with HIV were recorded during the study period. Their ages ranged from 18-63 years, with an average of 31 years (±6). The prevalence of depression among HIV-positive women in Bangui was estimated to be 54.7%. Having multiple children to care for (OR=1.93, 95% CI- 1.30-2.85, p=0.012), absence of income-generating activity (OR=2.18; 95% CI- 1.60-2.98, p=0.001), psychological pressure from the environment (OR=2.03, 95% CI- 1.14-4.18; p=0.003), the experience of stress (OR=3.47; 95% CI- 2.11-5.99; p<0.001) and being abandoned by a partner were the main factors associated with depression ( OR=2.94; 95% CI- 1.10-7.85; p=0.012).
Conclusions: Depression is highly prevalent among HIV-positive women in Bangui. Early detection and integrated psychosocial support are essential to address this public health concern.
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References
WHO. Mental Health and COVID-19: Early evidence of the pandemic’s impact: Scientific brief, 2 March 2022. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1. Accessed on 18 June 2025.
WHO. Depression and Other Common Mental Disorders. Available from: https://www.who.int/publications/i/item/depression-global-health-estimates. Accessed on 18 June 2025.
Murray CJL, Goerdt A, Koplan JP, Robine JM, Thuriaux MC, Van Ginneken JK, et al. The global burden of disease. A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Boston: Harvard School of Public Health; 1996:990.
Charlson F, Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394(10194):240‑8. DOI: https://doi.org/10.1016/S0140-6736(19)30934-1
Soklaridis S, Lin E, Lalani Y, Rodak T, Sockalingam S. Mental health interventions and supports during COVID-19 and other medical pandemics: a rapid systematic review of the evidence. Gen Hosp Psychiatr. 2020;66:133‑46. DOI: https://doi.org/10.1016/j.genhosppsych.2020.08.007
Remien RH, Stirratt MJ, Nguyen N, Robbins RN, Pala AN, Mellins CA. Mental health and HIV/AIDS: the need for an integrated response. AIDS Lond Engl. 2019;33(9):1411‑20. DOI: https://doi.org/10.1097/QAD.0000000000002227
Blank MB, Himelhoch SS, Balaji AB, Metzger DS, Dixon LB, Rose CE, et al. A multisite study of the prevalence of HIV with rapid testing in mental health settings. Am J Public Health. 2014;104(12):2377‑84. DOI: https://doi.org/10.2105/AJPH.2013.301633
Voundi EV, Kalla GCM, Kenfack JDT, Olen JPK, Essi MJ, Mbopi-Keou FX. Association between depression and viral load in people on antiretroviral treatment followed at the Yaoundé Central Hospital in Cameroon. Pan Afr Med J. 2022;41:320.
Yaya I, Landoh DE, Saka B, Patchali PM, Wasswa P, Aboubakari AS, et al. Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo. BMC Public Health. 2014;14:1308. DOI: https://doi.org/10.1186/1471-2458-14-1308
Wakibi SN, Ng’ang’a ZW, Mbugua GG. Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya. AIDS Res Ther. 2011;8:43. DOI: https://doi.org/10.1186/1742-6405-8-43
Oku AO, Owoaje ET, Ige OK, Oyo-Ita A. Prevalence and determinants of adherence to HAART amongst PLHIV in a tertiary health facility in south-south Nigeria. BMC Infect Dis. 2013;13:401. DOI: https://doi.org/10.1186/1471-2334-13-401
Waldron EM, Burnett-Zeigler I, Wee V, Ng YW, Koenig LJ, Pederson AB, et al. Mental health in women living with HIV: the unique and unmet needs. J Int Assoc Provid AIDS Care. 2021;20:2325958220985665. DOI: https://doi.org/10.1177/2325958220985665
Deshmukh NN, Borkar AM, Deshmukh JS. Depression and its associated factors among people living with HIV/AIDS: can it affect their quality of life? J Fam Med Prim Care. 2017;6(3):549. DOI: https://doi.org/10.4103/2249-4863.222016
Ministry of Planning and International Cooperation of the Central African Republic (MPCI). Multiple Indicator Cluster Survey (MICS), CAR 2018, Final Report. Bangui, MPCI; 2018:273.
Bernard C, Dabis F, de Rekeneire N. Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: a systematic review and meta-analysis. PloS One. 2017;12(8):e0181960. DOI: https://doi.org/10.1371/journal.pone.0181960
Bitew T, Hanlon C, Kebede E, Medhin G, Fekadu A. Antenatal depressive symptoms and maternal health care utilisation: a population-based study of pregnant women in Ethiopia. BMC Pregnancy Childbirth. 2016;16(1):301. DOI: https://doi.org/10.1186/s12884-016-1099-1
Longo JD, Simaleko MM, Diemer HS, Gresenguet G, Brücker G, Belec L. Risk factors for HIV infection among female sex workers in Bangui, Central African Republic. PLoS One. 2017;12(11):e0187654. DOI: https://doi.org/10.1371/journal.pone.0187654
Beck AT, Steer RA, Brown GK. Beck Depression Inventory. 2nd edn. San Antonio TX The Psychological Corporation; 1996. DOI: https://doi.org/10.1037/t00742-000
French National Authority for Health. Major depressive episode in adults: management in primary care. Summary of the good practice recommendation. 2017.
Yousuf A, Musa R, Isa MLM, Arifin SRM. Anxiety and depression among women living with HIV: Prevalence and Correlations. Clin Pract Epidemiol Ment Health. 2020;16:59‑66. DOI: https://doi.org/10.2174/1745017902016010059
African Union Mission in the Central African Republic (MISAC). CAR- Monitoring of gender-based violence and sexual violence. Infographic Bulletin No. 2; Bangui, Av. BB; No. 3129. 2015:25.
Jiang H, Chen S, Huang X, Huang R, Lin P, Cheng W. Prevalence of and factors associated with major depressive disorder among HIV-positive individuals in Guangdong, China. J Affect Disord. 2019;246:474-9. DOI: https://doi.org/10.1016/j.jad.2018.12.130
Mohamud AK, Ahmed OA, Mohamud AA, Dirie NI. Prevalence of and factors associated with depression among adult patients living with HIV/AIDs undergoing ART unit in Banadir hospital, Mogadishu Somalia. BMC Psychiatr. 2023;23(1):232. DOI: https://doi.org/10.1186/s12888-023-04723-x
Meffert SM, Neylan TC, McCulloch CE, Maganga L, Adamu Y, Kiweewa F, et al. East African HIV care: depression and HIV outcomes. Glob Ment Health Camb Engl. 2019;6:e9. DOI: https://doi.org/10.1017/gmh.2019.6
Hatcher AM, Tsai AC, Kumbakumba E, Dworkin SL, Hunt PW, Martin JN, et al. Sexual relationship power and depression among HIV-infected women in Rural Uganda. PloS One. 2012;7(12):e49821. DOI: https://doi.org/10.1371/journal.pone.0049821
Rancans E, Vrublevska J, Snikere S, Koroleva I, Trapencieris M. The point prevalence of depression and associated sociodemographic correlates in the general population of Latvia. J Affect Disord. 2014;156:104‑10. DOI: https://doi.org/10.1016/j.jad.2013.11.022
Coulibaly SP, Maïga FI, Landouré G, Dolo H, Mounkoro PP, Dara AE, et al. Factors associated with mental disorders in the psychiatric department of the university hospital centre of Point G in Mali. Mali Med. 2021;36(1):52‑7.
Lund C, Brooke-Sumner C, Baingana F, Baron EC, Breuer E, Chandra P, et al. Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Lancet Psychiatr. 2018;5(4):357‑69. DOI: https://doi.org/10.1016/S2215-0366(18)30060-9
World Federation for Mental Health (WFMH). Depression: A Global Crisis. World Healing Day. 2022. Disponible sur: http://www.who.int/mental_health/management/depression/wfmh_paper_depression_wmhd_2012.pdf. Accessed on 18 June 2025.
Asmare Eshetu D, Meseret S. Prevalence of Depression and Associated Factors among HIV/ AIDS Patients Attending ART Clinic at Debrebirhan Referral Hospital, North Showa, Amhara Region, Ethiopia. Clin Psychiatr. 2015. DOI: https://doi.org/10.21767/2471-9854.100003
World Health Organization (WHO). Violence against women: Key facts. Geneva. 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/violence-against-women. Accessed on 18 June 2025.
UN Office for the Coordination of Humanitarian Affairs(OCHA). Central African Republic. Humanitarian Situation Report. 2024;19. DOI: https://doi.org/10.18356/9789211071702c005
Lombardi BN, Jensen TM, Parisi AB, Jenkins M, Bledsoe SE. The relationship between a lifetime history of sexual victimization and perinatal depression: a systematic review and meta-analysis. Trauma Violence Abuse. 2023;24(1):139‑55. DOI: https://doi.org/10.1177/15248380211021611
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