%0 Journal Article
%T Risk Factors for Viral Non-Suppression among People Living with HIV and Major Depressive Disorder in Uganda
%A Lilian Bulage
%A Benedict Akimana
%A Justine D. Namuli
%A Seggane Musisi
%A Josephine Birungi
%A Micheal Etukoit
%A Ramin Mojtabai
%A Jean B. Nachega
%A Edward J. Mills
%A Etheldreda Nakimuli-Mpungu
%J World Journal of AIDS
%P 43-54
%@ 2160-8822
%D 2022
%I Scientific Research Publishing
%R 10.4236/wja.2022.122004
%X <strong>Background: </strong>Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. <strong>Method: </strong>A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder; we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (&lt;1000 viral copies/mL) and non-suppressed (¡Ý1000 viral copies/mL). We used generalized linear regression models to evaluate the factors associated with non-viral suppression. <strong>Results:</strong> We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ¡Ý 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). <strong>Conclusions:</strong> Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.
%K Depression
%K Suicide Risk
%K Anti-Retroviral Therapy
%K Viral Suppression
%K Uganda
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=116444