Anxiety, depression and treatment adherence among HIV-infected migrants

ABSTRACT

Diagnosing symptoms of psychological distress can be challenging in migrants living with HIV (MLWH) living in Western Europe. We evaluated the Hospital Anxiety and Depression Scale (HADS) as a screening tool for psychological distress. Additionally, the association between psychological distress and adherence to combination Antiretroviral Therapy (cART) was determined. Socio-demographic and clinical characteristics, psychosocial variables, and self-reported adherence to cART data were collected. 306/352 participants completed the HADS. A HADS+ (≥15, at risk for psychological distress) was found in 106/306. The Composite International Diagnostic Interview (CIDI) was completed by 60/106. The HADS was repeated in 58 participants as the time between the first HADS and the CIDI was more than three months. In 21/37 participants with a HADS+ (57%) within three months before the CIDI a diagnosis of depression or anxiety disorder based on the CIDI was found. Participants with a HADS+ were more likely to be non-adherent (71.3% vs. 43.6%). In a large group of MLWH in the Netherlands, 35% were at risk for symptoms of psychological distress. The HADS seems to be a suitable screening tool for MLWH.

KEYWORDS:

• HIV
• migrants
• adherence
• depression
• anxiety

Acknowledgements

The authors thank the participating patients for their time and willingness to contribute to this study. We also thank the physicians and nurses at Erasmus University Medical Center and Maasstad Hospital, and the members of the interview team, for their efforts. This work was supported by an unrestricted scientific grant by the Dutch Aids Fonds.

Study registration number

Netherlands Trial Registry Number (NTR) – NTR4941.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability

The data that support the findings of this study are available from the corresponding author, S.K. Been, upon reasonable request.

ORCID

S.K. Been http://orcid.org/0000-0002-5755-3306

Additional information

Funding

This work was supported by the Dutch Aids Fonds under grant (2011107).