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Depression and alcohol use disorder at antiretroviral therapy initiation led to disengagement from care in South Africa.

Abstract We sought to assess mental health at the time of antiretroviral therapy (ART) initiation and subsequent retention in care over a six-month follow-up period. A total of 136 people living with HIV in South Africa were administered surveys measuring demographic information and mental health indicators at the time of ART initiation. Follow-up was completed via chart abstraction to assess for six-month outcomes of retention in care and viral suppression. At enrollment, 45/136 (33%), 67/136 (49%), and 45/136 (33%) participants screened positive for depression, anxiety, and alcohol use disorder, respectively. After six months of follow-up, 96/136 (71%) participants remained in care; 35/87 (40.2%) participants who remained in care had a level <50 copies/mL. Those with depression (49% vs. 77% retained; p < 0.01) and those with alcohol use disorder (52% vs. 76% retained; p < 0.01) were less likely to be retained in care. In multivariable logistic regression, depression OR 3.46 (95% CI: 1.33, 7.97; p < 0.01) and alcohol abuse OR 3.89 (95% CI: 1.70, 8.97; p < 0.01) were independently associated with loss from care. These results emphasize the importance of mental health on early ART outcomes and the HIV care continuum.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 29281681
OWN - NLM
STAT- In-Data-Review
LR  - 20171227
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Depression and alcohol use disorder at antiretroviral therapy initiation led to
      disengagement from care in South Africa.
PG  - e0189820
LID - 10.1371/journal.pone.0189820 [doi]
AB  - We sought to assess mental health at the time of antiretroviral therapy (ART)
      initiation and subsequent retention in care over a six-month follow-up period. A 
      total of 136 people living with HIV in South Africa were administered surveys
      measuring demographic information and mental health indicators at the time of ART
      initiation. Follow-up was completed via chart abstraction to assess for six-month
      outcomes of retention in care and viral suppression. At enrollment, 45/136 (33%),
      67/136 (49%), and 45/136 (33%) participants screened positive for depression,
      anxiety, and alcohol use disorder, respectively. After six months of follow-up,
      96/136 (71%) participants remained in care; 35/87 (40.2%) participants who
      remained in care had a level &lt;50 copies/mL. Those with depression (49% vs. 77%
      retained; p &lt; 0.01) and those with alcohol use disorder (52% vs. 76% retained; p 
      &lt; 0.01) were less likely to be retained in care. In multivariable logistic
      regression, depression OR 3.46 (95% CI: 1.33, 7.97; p &lt; 0.01) and alcohol abuse
      OR 3.89 (95% CI: 1.70, 8.97; p &lt; 0.01) were independently associated with loss
      from care. These results emphasize the importance of mental health on early ART
      outcomes and the HIV care continuum.
FAU - Cichowitz, Cody
AU  - Cichowitz C
AUID- ORCID: http://orcid.org/0000-0002-9029-6508
AD  - Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
      of America.
FAU - Maraba, Noriah
AU  - Maraba N
AD  - Aurum Institute, Johannesburg, South Africa.
FAU - Hamilton, Robin
AU  - Hamilton R
AD  - Private practice clinical psychologist, Johannesburg, South Africa.
FAU - Charalambous, Salome
AU  - Charalambous S
AD  - Aurum Institute, Johannesburg, South Africa.
AD  - University of the Witwatersrand School of Public Health, Johannesburg, South
      Africa.
FAU - Hoffmann, Christopher J
AU  - Hoffmann CJ
AD  - Aurum Institute, Johannesburg, South Africa.
AD  - University of the Witwatersrand School of Public Health, Johannesburg, South
      Africa.
AD  - Division of Infectious Disease, Johns Hopkins University School of Medicine,
      Baltimore, Maryland, United States of America.
LA  - eng
PT  - Journal Article
DEP - 20171227
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/12/28 06:00
MHDA- 2017/12/28 06:00
CRDT- 2017/12/28 06:00
PHST- 2017/08/10 00:00 [received]
PHST- 2017/12/02 00:00 [accepted]
PHST- 2017/12/28 06:00 [entrez]
PHST- 2017/12/28 06:00 [pubmed]
PHST- 2017/12/28 06:00 [medline]
AID - 10.1371/journal.pone.0189820 [doi]
AID - PONE-D-17-29668 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 27;12(12):e0189820. doi: 10.1371/journal.pone.0189820.
      eCollection 2017.