Depression and PrEP uptake, interruption, and adherence among young women in Uganda

ABSTRACT

Depression is a common cause of morbidity globally and can impact adherence to medications, posing challenges to medication-based HIV prevention. The objectives of this work are to describe the frequency of depression symptoms in a cohort of 499 young women in Kampala, Uganda and to determine the association of depression symptoms with use of HIV pre-exposure prophylaxis (PrEP). Mild or greater depression, assessed by the patient health questionnaire (PHQ-9), was experienced by 34% of participants at enrollment. Participants with mild depression symptoms tended to uptake PrEP, request PrEP refills, and adhere to PrEP with similar frequency to women with no/minimal signs of depression. These findings highlight opportunities to leverage existing HIV prevention programs to identify women who may benefit from mental health services and may not otherwise be screened.

Trial registration: ClinicalTrials.gov identifier: NCT03464266..

KEYWORDS:

• Mental health
• Depression
• PrEP
• HIV prevention

Acknowledgements

We are grateful to the participants who gave of their time, energy, and dedication. We are also grateful to the study team for their careful work.

The Kampala Women’s Bone Study Team

University of Washington: Renee Heffron (protocol chair), Jade Boyer, Susan Morrison, Gabrielle Stein, Katherine Thomas, Elena A Rechkina, Kenneth Mugwanya, Jared M. Baeten, Andrew Hoofnagle

Infectious Diseases Institute: Andrew Mujugira (site investigator), Timothy Muwonge, Timothy Ssebuliba, Felix Bambia, Josephine Badaru, Monica Bagaya, Oliver Sapiri, Rogers Nsubuga, Agnes Nakyanzi, Lydia Valarie Nambala, Florence Nambi, Olivia Nampewo, Robert Nyanzi, Miriam Nampala Ryder, Mary Nakayiza

Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda: Flavia Matovu Kiweewa, Andrew Kateregga, Stephen Bule

Columbia University: Mike Yin

Duke University: Christina Wyatt

Johns Hopkins University: Mark Marzinke

University of Colorado: Peter Anderson

Gilead Sciences: FTC/TDF donation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are available upon request from [email protected].

Additional information

Funding

The study was funded by the Eunice Kennedy Shriver National Institute for Child Health and Human Development (R01HD089843) and FTC/TDF medication was donated by Gilead Sciences Inc. RH was supported by K24MH123371.