Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV: the West Africa IeDEA collaboration

Background To encourage successful aging, the psychological domain must not be neglected. As depression, one of the most common psychiatric disorders in PLHIV, has negative impact on both mental and physical health, the prevalence and the factors associated with the presence of severe depressive symptoms in older PLHIV living in West Africa need to be well understood. Methods Data from PLHIV aged ≥50 years old and on ART since ≥6 months were collected in three clinics (two in Côte d’Ivoire, one in Senegal) participating to the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. The severity of the depressive symptoms was measured using the Center for Epidemiological Studies Depression scale (CES-D) and associated factors were identified using logistic regression. Results The median age of the 334 PLHIV included in the study was 56.7 (53.5-61.1) years old, 57.8% were female and 87.1% had an undetectable viral load. The prevalence of severe depressive symptoms was 17.9% [95% Confidence Interval: 13.8 - 22.0]. PLHIV with severe depressive symptoms were more likely to have no professional activity, and to be current or former tobacco smokers but were less likely to be overweight or obese. Conclusions The prevalence of severe depressive symptoms is high among older PLHIV living in West Africa. How to integrate the measurement and the management of depressive symptoms in the standard of care should be investigated, both for older PLHIV on ART but also for newly diagnosed older patients, in order to achieve the 90-90-90 objectives.