A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy
Introduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by in...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Hindawi Limited
2023-01-01
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| Series: | Psychiatry Journal |
| Online Access: | http://dx.doi.org/10.1155/2023/1986908 |
| _version_ | 1811175557376770048 |
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| author | Rwamahe Rutakumwa Christine Tusiime Richard Stephen Mpango Leticia Kyohangirwe Pontiano Kaleebu Vikram Patel Eugene Kinyanda |
| author_facet | Rwamahe Rutakumwa Christine Tusiime Richard Stephen Mpango Leticia Kyohangirwe Pontiano Kaleebu Vikram Patel Eugene Kinyanda |
| author_sort | Rwamahe Rutakumwa |
| collection | DOAJ |
| description | Introduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. Methods. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were conducted with 17 persons living with HIV who completed/interrupted depression treatment but had not been interviewed. Only data collected from persons living with HIV and lay health workers were analysed for the purpose of this paper. A narrative thematic approach was used in data analysis. Findings. There were several pathways through which lack of family social support reportedly led to depression: worries about disclosure in discordant relationships, false perceptions of social support, stigmatisation and discrimination, and domestic violence. Economic/poverty and other causes were identified, but their role was less significant or moderated by family social support. Conclusion. Family social support plays a dominant role—both directly and indirectly—in influencing depression risk. We propose the mainstreaming of formal psychosocial support and a shift from individual to family-focused counselling that targets both persons living with HIV and their family. |
| first_indexed | 2024-04-10T19:38:50Z |
| format | Article |
| id | doaj.art-774e03942d4b476c9b48e774e95e9021 |
| institution | Directory Open Access Journal |
| issn | 2314-4335 |
| language | English |
| last_indexed | 2024-04-10T19:38:50Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Psychiatry Journal |
| spelling | doaj.art-774e03942d4b476c9b48e774e95e90212023-01-30T00:11:00ZengHindawi LimitedPsychiatry Journal2314-43352023-01-01202310.1155/2023/1986908A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for PolicyRwamahe Rutakumwa0Christine Tusiime1Richard Stephen Mpango2Leticia Kyohangirwe3Pontiano Kaleebu4Vikram Patel5Eugene Kinyanda6Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research UnitMedical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research UnitDepartment of Global Health and Social MedicineMedical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research UnitIntroduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. Methods. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were conducted with 17 persons living with HIV who completed/interrupted depression treatment but had not been interviewed. Only data collected from persons living with HIV and lay health workers were analysed for the purpose of this paper. A narrative thematic approach was used in data analysis. Findings. There were several pathways through which lack of family social support reportedly led to depression: worries about disclosure in discordant relationships, false perceptions of social support, stigmatisation and discrimination, and domestic violence. Economic/poverty and other causes were identified, but their role was less significant or moderated by family social support. Conclusion. Family social support plays a dominant role—both directly and indirectly—in influencing depression risk. We propose the mainstreaming of formal psychosocial support and a shift from individual to family-focused counselling that targets both persons living with HIV and their family.http://dx.doi.org/10.1155/2023/1986908 |
| spellingShingle | Rwamahe Rutakumwa Christine Tusiime Richard Stephen Mpango Leticia Kyohangirwe Pontiano Kaleebu Vikram Patel Eugene Kinyanda A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy Psychiatry Journal |
| title | A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy |
| title_full | A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy |
| title_fullStr | A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy |
| title_full_unstemmed | A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy |
| title_short | A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy |
| title_sort | qualitative exploration of causes of depression among persons living with hiv receiving antiretroviral therapy in uganda implications for policy |
| url | http://dx.doi.org/10.1155/2023/1986908 |
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