Effectiveness of depression interventions for people living with HIV in Sub-Saharan Africa: A systematic review & meta-analysis of psychological & immunological outcomes

Ruth Verity Passchier*, Melanie Amna Abas, Ikenna D. Ebuenyi, Carmine M. Pariante

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

This meta-analytic review evaluated the effectiveness of depression interventions on the psychological and immunological outcomes of people living with HIV in sub-Saharan Africa. 14 studies, yielding 932 participants were eligible. A random-effects models indicated that depression interventions were followed by large reductions in depression scores (effect size = 1.86, 95% CI = 1.71, 2.01, p < 0.01). No significant effect on immune outcome was observed, however there was a trend toward immune improvement of medium effect size (effect size on CD4 count and/or viral suppression = 0.57, 95% CI = −0.06, 1.20, p = 0.08). Pharmacological interventions appeared to have a significantly larger improvement in depression scores than psychological interventions. The greatest improvement in immune status was demonstrated in psychological treatments which incorporated a component to enhance HIV medication adherence, however these results did not reach significance. Small sample sizes and highly heterogeneous analysis necessitate caution in interpretation. The results of this meta-analysis should thus be treated as preliminary evidence and used to encourage further studies of immunopsychiatry in HIV in sub-Saharan Africa.

Original languageEnglish
Pages (from-to)261-273
Number of pages13
JournalBrain, Behavior, and Immunity
Volume73
Early online date13 May 2018
DOIs
Publication statusPublished - Oct 2018

Keywords

  • CD4
  • Depression
  • HIV/AIDS
  • Immunopsychiatry
  • Intervention
  • Meta-analysis
  • Psychoneuroimmunology
  • Review
  • Sub-Saharan Africa
  • Viral load

Fingerprint

Dive into the research topics of 'Effectiveness of depression interventions for people living with HIV in Sub-Saharan Africa: A systematic review & meta-analysis of psychological & immunological outcomes'. Together they form a unique fingerprint.

Cite this