Routine Screening for Depression: Identifying a Challenge for Successful HIV Care

Introduction: Individuals with HIV experience fluctuating levels of distress throughout the course of HIV infection. This study was conducted to examine the associations of depressive symptomatology on HIV disease among individuals who are engaged in routine medical care. Methods: This cross-sectional study examined the prevalence of depressive symptoms that were measured as part of a standard of care behavioral assessment among individuals at an urban HIV clinic in Midwest. Results: A total of 515 individuals participated in the study, the majority of whom was male and African American. One-quarter of the sample endorsed symptoms of Other Depressive Disorder, while 18% endorsed symptoms of Major Depressive Disorder as measured by the Patient Health Questionnaire-9 (PHQ-9). The odds of expressing depressive disorders symptoms was increased by being unemployed , having a minor dependent, <$0,000 annual income, and having detectable HIV viral load when controlling for gender, race, income, and education. Among those on HAART, individuals with depressive disorders were more likely to have HIV viral loads > 400 copies/mL. Nearly 15% of the sample endorsed having suicidal thoughts at least once in the past two weeks. Individuals who were unemployed were at 2.1 times the risk of suicidal ideation and those with an annual income <$0,000 were 1.2 times more likely than those who reported >$10,000 annual income. Conclusions: Given the association between depressive symptomatology and poor rates of HIV viral suppression, screening and appropriate interventions for depressive symptoms are warranted in the HIV outpatient setting to improve outcomes.