Dissertation/Thesis Abstract

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Impact of Depression and Anxiety on Antiretroviral Therapy Initiation and Adherence among Newly Diagnosed HIV-Infected Men Who Have Sex with Men in China
by Tao, Jun, Ph.D., Vanderbilt University, 2016, 128; 13834917
Abstract (Summary)

Background: Depression is common among people living with HIV (PLHIV). Studies on the relationship between depression and use of antiretroviral therapy (ART) are inconclusive.

Methods: A meta-analysis was conducted to summarize the relationship between depression and ART use in PLHIV. Ten electronic databases and multiple websites of conferences and dissertations were searched. A random effects meta-analysis was performed to pool the odds ratio estimates from eligible studies. Subgroup analyses and meta-regression were conducted for moderator analysis. Sensitivity analysis was performed to find influential studies. A funnel plot, the Egger test, and the trim and fill analysis were used to detect publication bias.

Results: The pooled sample size was 7,375 with the inclusion of nine eligible studies. The pooled prevalence of depression was 41% (95% confidence interval [CI]: 29%-53%). The pooled ART use rate was 52% (95% CI: 37%-67%). PLHIV with depression were 14% less likely (pooled odds ratio [OR]: 0.86; 95% CI: 0.71- 1.05) to use ART than those without depression. Subgroup analyses showed that depression was significantly associated with no ART use (pooled OR: 0.84; 95% CI: 0.71-0.99) among studies with a prospective study design (11 populations from 9 studies). Moderator analyses did not show any statistically significant effects. The publication bias analyses showed no evidence of small study effects.

Conclusions: Depression was associated with non-use of ART among PLHIV. Studies are needed to explore this association in other countries with varied populations, as most published studies have been conducted in the United States.

Indexing (document details)
Advisor: Vermund, Sten H.
Commitee: Amico, K. Rivet, Kipp, Aarom M., Qian, Han-Zhu, Shepherd, Bryan E., Vermund, Sten H.
School: Vanderbilt University
Department: Epidemiology
School Location: United States -- Tennessee
Source: DAI-B 80/07/(E), Dissertation Abstracts International
Subjects: Health sciences, Environmental science
Keywords: Adherence, Antiretroviral therapy, Depression/anxiety, HIV, Initiation, Men who have sex with men
Publication Number: 13834917
ISBN: 9780438820081
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