Depressive symptoms among people living with HIV in Northern Tanzania: The role of family history, social support, and maladaptive coping

Background Depression is a common mental disorder among people living with HIV (PLWH) and is driven by both neuroimmunological and psychosocial pathways. In turn, depressive symptoms worsen HIV outcomes through reduced adherence, risk behaviors, and impaired immune function. This study aimed to determine the prevalence of depressive symptoms and identify associated factors among PLWH attending health facilities in northern Tanzania. Methodology We conducted a cross-sectional study (September–October 2023) in four Care and Treatment Clinics (CTCs) across three health system levels in Moshi Municipality. Study sites were selected purposively to represent tertiary, secondary, and primary care. Within each site, adult (≥18 years) clients on ART for ≥6 months were sampled using systematic random sampling. Standardized instruments included a sociodemographic questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Duke-UNC Functional Social Support Questionnaire (FSSQ), the Brief COPE, and a 12-item HIV-related stigma scale. Data were entered and analyzed using STATA version 16. Logistic regression analysis was performed to identify associations between depressive symptoms and various independent variables. Results A total of 598 clients participated, just above half (56%) from the secondary health facility level, and nearly three-quarters (70.9%) of participants were female. The prevalence of depressive symptoms was 14%. Participants reported having a family history of mental illness, good social support and predominantly use maladaptive coping strategies were more likely to report having depressive symptoms (AOR 2.15, 95%CI: 1.12–4.13; P 0.022), (AOR 8.19, 95%CI: 1.29–51.92; P 0.026), (AOR 3.98, 95%CI: 2.62–6.05; P < 0.001) respectively. Conclusion Depressive symptoms are common among PLWH receiving HIV care and treatment in northern Tanzania, and are associated with a reported family history of mental illness, predominant use of maladaptive coping, and even good social support. Thus, more studies need to be done on the relationship between depressive symptoms and social support among PLWH. Integrating mental health intervention into HIV services and providing personalized interventions focused on addressing maladaptive coping and social support are key to reducing depression among people living with HIV.