Depression in People With HIV During the COVID-19 Pandemic in Four African Countries

Background People with HIV (PWH) may be vulnerable to worsening mental health during disease outbreaks. The African Cohort Study enrolls PWH in Kenya, Uganda, Tanzania, and Nigeria. Methods Every six months, participants completed physical evaluations, medical record abstraction, and questionnaires including the Center for Epidemiologic Studies Depression Scale. Multivariable logistic regression models with generalized estimating equations estimated adjusted odds ratios for factors associated with a positive depression screen. Results Among 2,067 participants, a positive depression screen was observed at 3.0% of visits pre-COVID-19 and peaked at 5.1% during the Delta surge. Participants who screened for depression were more likely to be aged ≥50 years and female. After adjustment, only the Delta surge was associated with a near-two-fold increased odds of a positive depression screen compared with the pre-COVID-19 period. Conclusions : Depressive symptoms among PWH increased early in the pandemic. Mental health support for PWH should be prioritized during disease outbreaks.