Anxiety and depression assessment prior to initiating antiretroviral treatment in Brazil

Abstract

A cross-sectional study was carried out with 386 patients who received their first anti-retroviral prescription between May 2001 and May 2002 in public AIDS referral centers in Belo Horizonte (Brazil). The main objective was to assess the prevalence and factors associated with anxiety and depression among HIV-infected patients initiating antiretroviral treatment using the Hospital Anxiety and Depression Scale. Clinical, behavioural and demographic data were collected from interviews and medical charts. Multivariate analysis was carried out by logistic regression. Prevalence of moderate to severe anxiety and depression were 35.8% and 21.8%, respectively. Female gender, low schooling, lack of health insurance, attendance to psychotherapy, difficulty in accessing health services and exposure category were independently associated with anxiety. On the other hand, female gender, lack of health insurance, low income, living alone, and lacking a sexual partner in the last month were independently associated with depression. This study highlights the importance of detecting psychological distress by simple screening methods in the HIV/AIDS setting, where the prevalence of anxiety and depression is considerably high, so proper intervention can be established soon in the treatment course.

Acknowledgments

This study was financed in the framework of the ATAR Project (Adherence Study Among Patients Initiating Antiretroviral Treatment), sponsored by the Pan-American Health Organization and the AIDS National Program of the Brazilian Ministry of Health (PN-DST/AIDS Brasil – UNESCO 914/BRA/3014) and was developed by the Research Group on Epidemiology and Health Services Evaluation (Grupo de Pesquisas em Epidemiologia e Avaliação em Saúde – GPEAS) from the Federal University of Minas Gerais, Brazil.