Global mental health (Cambridge, England)最新文献

{"title":"Suicide on Facebook-the tales of unnoticed departure in Bangladesh.","authors":"Tanjir Rashid Soron,&nbsp;Sheikh Mohammed Shariful Islam","doi":"10.1017/gmh.2020.5","DOIUrl":"https://doi.org/10.1017/gmh.2020.5","url":null,"abstract":"<p><p>Facebook has transformed social communication and offers the opportunity to share personal thoughts to people including suicide ideas, plans and attempts. Suicide after Facebook posts has been reported in different parts of the world and it has become a potential area of research for suicide prevention. The analysis of Facebook posts prior to suicide or Facebook live streaming may help in understanding the etiological factors, patterns of communication and possible prevention approaches for a particular community. However, there is a dearth of evidence about suicide incidents after Facebook posts and Facebook live streaming in low and middle-income countries. This study aims to explore the trends and phenomena of suicide after Facebook posts and live streaming in Bangladesh. We conducted an online search using the Google, Facebook and five daily online newspaper archives from 15th August to 15th September 2019. Two research assistants independently conducted the initial searching to find out people who committed suicide after Facebook posts or live streamed suicide in Bangladesh and documented 21 cases. After further evaluation of each of the 21 cases we confirmed 19 cases that met the selection criteria. All of them were under 35-years of age. We observed sucide after Facebook posts were more common in male(78%) e and students. Hanging was the most frequently used method of suicide followed by poisoning. Their Facebook posts and livestream videos indicated relationship problems, academic stress and mental disorders were the common stressors for their suicide. This study lays the foundation for the future researchers to work on suicidal posts on Facebook in Bangladesh and develop culture-specific, real-time suicide preventive systems using a social media platform.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e12"},"PeriodicalIF":3.9,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38221027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextualizing and pilot testing the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) to primary healthcare workers in Kilifi, Kenya.","authors":"Mary A Bitta,&nbsp;Symon M Kariuki,&nbsp;Anisa Omar,&nbsp;Leonard Nasoro,&nbsp;Monica Njeri,&nbsp;Cyprian Kiambu,&nbsp;Linnet Ongeri,&nbsp;Charles R J C Newton","doi":"10.1017/gmh.2020.6","DOIUrl":"https://doi.org/10.1017/gmh.2020.6","url":null,"abstract":"<p><strong>Background: </strong>Little data exists about the methodology of contextualizing version two of the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) in resource-poor settings. This paper describes the contextualisation and pilot testing of the guide in Kilifi, Kenya.</p><p><strong>Methods: </strong>Contextualisation was conducted as a collaboration between the KEMRI-Wellcome Trust Research Programme (KWTRP) and Kilifi County Government's Department of Health (KCGH) between 2016 and 2018. It adapted a mixed-method design and involved a situational analysis, stakeholder engagement, local adaptation and pilot testing of the adapted guide. Qualitative data were analysed using content analysis to identify key facilitators and barriers to the implementation process. Pre- and post-training scores of the adapted guide were compared using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Human resource for mental health in Kilifi is strained with limited infrastructure and outdated legislation. Barriers to implementation included few specialists for referral, unreliable drug supply, difficulty in translating the guide to Kiswahili language, lack of clarity of the roles of KWTRP and KCGH in the implementation process and the unwillingness of the biomedical practitioners to collaborate with traditional health practitioners to enhance referrals to hospital. In the adaptation process, stakeholders recommended the exclusion of child and adolescent mental and behavioural problems, as well as dementia modules from the final version of the guide. Pilot testing of the adapted guide showed a significant improvement in the post-training scores: 66.3% (95% CI 62.4-70.8) <i>v.</i> 76.6% (95% CI 71.6-79.2) (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The adapted mhGAP-IG version two can be used across coastal Kenya to train primary healthcare providers. However, successful implementation in Kilifi will require a review of new evidence on the burden of disease, improvements in the mental health system and sustained dialogue among stakeholders.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e11"},"PeriodicalIF":3.9,"publicationDate":"2020-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38221026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philanthropy for global mental health 2000-2015.","authors":"Valentina Iemmi","doi":"10.1017/gmh.2020.2","DOIUrl":"https://doi.org/10.1017/gmh.2020.2","url":null,"abstract":"<p><strong>Background: </strong>Mental disorders are the leading cause of years lived with disability worldwide. While over three-quarters of people with mental disorders live in low- and middle-income countries (LMICs) and effective low-cost interventions are available, resource commitments are extremely limited. This paper seeks to understand the role of philanthropy in this area and to inform discussions about how to increase investments.</p><p><strong>Methods: </strong>Novel analyses of a dataset on development assistance for health were conducted to study philanthropic development assistance for mental health (DAMH) in 156 countries between 2000 and 2015.</p><p><strong>Results: </strong>Philanthropic contributions more than doubled over 16 years, accounting for one-third (US$364.1 million) of total DAMH 2000-2015. However, across health conditions, mental disorders received the lowest amount of philanthropic development assistance for health (0.5%). Thirty-seven of 156 LMICs received no philanthropic DAMH between 2000 and 2015 and just three LMICs (Antigua and Barbuda, Grenada, Saint Vincent and the Grenadines) received more than US$1 philanthropic DAMH per capita over the entire period. Eighty-one percent of philanthropic DAMH was disbursed to unspecified locations.</p><p><strong>Conclusions: </strong>Philanthropic donors are potentially playing a critical role in DAMH, and the paper identifies challenges and opportunities for increasing their impact in sustainable financing for mental health.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e9"},"PeriodicalIF":3.9,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38221023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health disorders and utilization of mental healthcare services in United Nations personnel.","authors":"Adam D Brown,&nbsp;Katharina Schultebraucks,&nbsp;Meng Qian,&nbsp;Meng Li,&nbsp;Danny Horesh,&nbsp;Carol Siegel,&nbsp;Yosef Brody,&nbsp;Abdalla Mansour Amer,&nbsp;Rony Kapel Lev-Ari,&nbsp;Francis Mas,&nbsp;Charles R Marmar,&nbsp;Jillann Farmer","doi":"10.1017/gmh.2019.29","DOIUrl":"https://doi.org/10.1017/gmh.2019.29","url":null,"abstract":"<p><strong>Background: </strong>United Nations (UN) personnel address a diverse range of political, social, and cultural crises throughout the world. Compared with other occupations routinely exposed to traumatic stress, there remains a paucity of research on mental health disorders and access to mental healthcare in this population. To fill this gap, personnel from UN agencies were surveyed for mental health disorders and mental healthcare utilization.</p><p><strong>Methods: </strong>UN personnel (<i>N</i> = 17 363) from 11 UN entities completed online measures of generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), trauma exposure, mental healthcare usage, and socio-demographic information.</p><p><strong>Results: </strong>Exposure to one or more traumatic events was reported by 36.2% of survey responders. Additionally, 17.9% screened positive for GAD, 22.8% for MDD, and 19.9% for PTSD. Employing multivariable logistic regressions, low job satisfaction, younger age (<35 years of age), greater length of employment, and trauma exposure on or off-duty was significantly associated with all the three disorders. Among individuals screening positive for a mental health disorder, 2.05% sought mental health treatment within and 10.01% outside the UN in the past year.</p><p><strong>Conclusions: </strong>UN personnel appear to be at high risk for trauma exposure and screening positive for a mental health disorder, yet a small percentage screening positive for mental health disorders sought treatment. Despite the mental health gaps observed in this study, additional research is needed, as these data reflect a large sample of convenience and it cannot be determined if the findings are representative of the UN.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e5"},"PeriodicalIF":3.9,"publicationDate":"2020-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.29","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37743717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a comprehensive, sustained community mental health system in post-earthquake Haiti, 2010-2019.","authors":"G Raviola,&nbsp;A Rose,&nbsp;J R Fils-Aimé,&nbsp;T Thérosmé,&nbsp;E Affricot,&nbsp;C Valentin,&nbsp;S Daimyo,&nbsp;S Coleman,&nbsp;W Dubuisson,&nbsp;J Wilson,&nbsp;H Verdeli,&nbsp;G Belkin,&nbsp;G Jerome,&nbsp;E Eustache","doi":"10.1017/gmh.2019.33","DOIUrl":"https://doi.org/10.1017/gmh.2019.33","url":null,"abstract":"<p><p>Between 2010 and 2019 the international health care organization Partners In Health (PIH) and its sister organization Zanmi Lasante (ZL) mounted a long-term response to the 2010 Haiti earthquake, focused on mental health. Over that time, implementing a Theory of Change developed in 2012, the organization successfully developed a comprehensive, sustained community mental health system in Haiti's Central Plateau and Artibonite departments, directly serving a catchment area of 1.5 million people through multiple diagnosis-specific care pathways. The resulting ZL mental health system delivered 28 184 patient visits and served 6305 discrete patients at ZL facilities between January 2016 and September 2019. The experience of developing a system of mental health services in Haiti that currently provides ongoing care to thousands of people serves as a case study in major challenges involved in global mental health delivery. The essential components of the effort to develop and sustain this community mental health system are summarized.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e6"},"PeriodicalIF":3.9,"publicationDate":"2020-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37743718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression among TB patients and associated factors in Kathmandu Valley, Nepal.","authors":"P Shrestha,&nbsp;U K Subba,&nbsp;M Brouwer,&nbsp;A C Sweetland","doi":"10.1017/gmh.2019.28","DOIUrl":"https://doi.org/10.1017/gmh.2019.28","url":null,"abstract":"<p><strong>Introduction: </strong>When tuberculosis (TB) and depression co-occur, there is greater risk for comorbidities, disability, suffering, and health-related costs. Depression is also associated with poor treatment adherence in patients with TB. The major aim of this study was to assess the symptoms of depression and associated factors among TB patients currently receiving directly observed treatment short-course (DOTS) treatment.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among TB patients currently undergoing treatment in 27 DOTS centers in three districts of Kathmandu Valley. The study included 250 TB patients within 2 months of treatment initiation, aged 18 years and above. The previously validated Nepali Patient Health Questionnaire (PHQ-9) was used to screen for depression and semi-structured interviews were conducted to collect socio-demographic information and other factors related to TB and/or depression. Data analysis was conducted using IBM SPSS Statistics version 20.</p><p><strong>Results: </strong>The study found the mean PHQ Score to be 2.84 (s.d. 4.92, range 0-25). Among the respondents, 10% (<i>n</i> = 25) had PHQ-9 scores ⩾10, suggestive of probable depression. Multivariate linear regression indicated that depressive symptoms were significantly associated with being separated/widowed/divorced (<i>p</i> = 0.000) and having lower education (0.003). In addition, smoking (<i>p</i> = 0.02), alcohol use (<i>p</i> = 0.001), and experience of side effects from TB medications (<i>p</i> = 0.001) were risk factors for higher PHQ-9 scores.</p><p><strong>Conclusions: </strong>Our findings suggest that patients on TB treatment have higher risk of depression and efforts should be made by the National Tuberculosis Program to address this issue.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e4"},"PeriodicalIF":3.9,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.28","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37658963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Law enforcement and mental health clinician partnerships in global mental health: outcomes for the Crisis Intervention Team (CIT) model adaptation in Liberia, West Africa.","authors":"Mina Boazak,&nbsp;Sarah Yoss,&nbsp;Brandon A Kohrt,&nbsp;Wilfred Gwaikolo,&nbsp;Pat Strode,&nbsp;Michael T Compton,&nbsp;Janice Cooper","doi":"10.1017/gmh.2019.31","DOIUrl":"https://doi.org/10.1017/gmh.2019.31","url":null,"abstract":"<p><strong>Background: </strong>The Crisis Intervention Team (CIT) model is a law enforcement strategy that aims to build alliances between the law enforcement and mental health communities. Despite its success in the United States, CIT has not been used in low- and middle-income countries. This study assesses the immediate and 9-month outcomes of CIT training on trainee knowledge and attitudes.</p><p><strong>Methods: </strong>Twenty-two CIT trainees (14 law enforcement officers and eight mental health clinicians) were evaluated using pre-developed measures assessing knowledge and attitudes related to mental illness. Evaluations were conducted prior to, immediately after, and 9 months post training.</p><p><strong>Results: </strong>The CIT training produced improvements both immediately and 9 months post training in knowledge and attitudes, suggesting that CIT can benefit law enforcement officers even in extremely low-resource settings with limited specialized mental health service infrastructure.</p><p><strong>Conclusion: </strong>These findings support further exploration of the benefits of CIT in highly under-resourced settings.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e2"},"PeriodicalIF":3.9,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.31","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37658962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of depression in people with newly diagnosed tuberculosis in Ethiopia: a cohort study.","authors":"Fentie Ambaw,&nbsp;Rosie Mayston,&nbsp;Charlotte Hanlon,&nbsp;Atalay Alem","doi":"10.1017/gmh.2019.27","DOIUrl":"https://doi.org/10.1017/gmh.2019.27","url":null,"abstract":"<p><strong>Background: </strong>Cross-sectional studies show that the prevalence of comorbid depression in people with tuberculosis (TB) is high. The hypothesis that TB may lead to depression has not been well studied. Our objectives were to determine the incidence and predictors of probable depression in a prospective cohort of people with TB in primary care settings in Ethiopia.</p><p><strong>Methods: </strong>We assessed 648 people with newly diagnosed TB for probable depression using Patient Health Questionnaire, nine-item (PHQ-9) at the time of starting their anti-TB medication. We defined PHQ-9 scores 10 and above as probable depression. Participants without baseline probable depression were assessed at 2 and 6 months to measure incidence of depression. Incidence rates per 1000-person months were calculated. Predictors of incident depression were identified using Poisson regression.</p><p><strong>Results: </strong>Two hundred and ninety-nine (46.1%) of the participants did not have probable depression at baseline. Twenty-two (7.4%) and 26 (8.7%) developed depression at 2 and 6 months of follow up. The incidence rate of depression between baseline and 2 months was 73.6 (95% CI 42.8-104.3) and between baseline and 6 months was 24.2 (95% CI 14.9-33.5) per 1000 person-months respectively. Female sex (adjusted <i>β</i> = 0.22; 95% CI 0.16-0.27) was a risk factor and perceived social support (adjusted <i>β</i> = -0.14; 95% CI -0.24 to -0.03) was a protective factor for depression onset.</p><p><strong>Conclusion: </strong>There was high incidence of probable depression in people undergoing treatment for newly diagnosed TB. The persistence and incidence of depression beyond 6 months need to be studied. TB treatment guidelines should have mental health component.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e1"},"PeriodicalIF":3.9,"publicationDate":"2020-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.27","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37658961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of a stepped-care brief intervention to help psychologically-distressed women displaced by conflict in Bogotá, Colombia.","authors":"J M Shultz,&nbsp;H Verdeli,&nbsp;Á Gómez Ceballos,&nbsp;L J Hernandez,&nbsp;Z Espinel,&nbsp;L Helpman,&nbsp;Y Neria,&nbsp;R Araya","doi":"10.1017/gmh.2019.26","DOIUrl":"https://doi.org/10.1017/gmh.2019.26","url":null,"abstract":"<p><strong>Background: </strong>Colombia's 6.5 million internally displaced persons (IDPs) have been exposed to trauma, loss, and hardships. Common mental disorders (CMDs) are prevalent in this group, yet there are few evidence-based psychosocial interventions for this population. We assessed the feasibility and acceptability of a stepped-care intervention for women IDPs in Bogota, Colombia.</p><p><strong>Methods: </strong>Feasibility to recruit participants for an intervention trial, to screen for CMDs and displacement-related traumas, to refer high-risk cases to professional consultation, to implement evidence-based interpersonal counseling (IPC) for women with diagnosed CMDs, to retain participants in the intervention, and to conduct follow-up assessments was assessed. Assessment instruments were validated. The intervention was delivered by trained outreach personnel. Intervention acceptability was assessed by monitoring session attendance, dropout rates, and satisfaction. Potential efficacy was evaluated with pre- and post-intervention measures of CMDs.</p><p><strong>Results: </strong>We recruited 279 women IDPs into the intervention. On screening, 177 (63.4%) had symptom levels suggesting a CMD. Participants endorsed a wide range of displacement-related exposures. Most participants receiving IPC decreased their symptom levels at follow-up. Many participants did not complete the recommended number of IPC sessions; loss to follow-up was 30%. The performance of the outreach personnel improved after the initial intervention team was replaced with community members trained to deliver the intervention. The Bogotá health system was unable to reliably accommodate emergency psychiatric referrals.</p><p><strong>Conclusions: </strong>The IPC intervention shows promise, but significant challenges remain for improving reach, adherence, and participant retention. We identified strategies and partnerships to redress some of the main study limitations.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e28"},"PeriodicalIF":3.9,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37658960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"East African HIV care: depression and HIV outcomes.","authors":"S M Meffert,&nbsp;T C Neylan,&nbsp;C E McCulloch,&nbsp;L Maganga,&nbsp;Y Adamu,&nbsp;F Kiweewa,&nbsp;J Maswai,&nbsp;J Owuoth,&nbsp;C S Polyak,&nbsp;J A Ake,&nbsp;V G Valcour","doi":"10.1017/gmh.2019.6","DOIUrl":"https://doi.org/10.1017/gmh.2019.6","url":null,"abstract":"<p><strong>Importance: </strong>Depression is a common co-morbidity for people living with HIV (PLWH) and is associated with elevated plasma HIV RNA levels. While depression correlates with deficits in antiretroviral (ARV) adherence, little data exist to inform the relationship between depression and HIV vial load more broadly.</p><p><strong>Objective: </strong>To examine the relationship between depression and viral load in the African Cohort Study (AFRICOS) independently of ARV adherence.</p><p><strong>Design: </strong>PLWH in Kenya, Uganda and Tanzania underwent screening for depression using the Center for Epidemiologic Studies Depression Scale (CESD) upon enrollment at AFRICOS HIV care sites.</p><p><strong>Setting: </strong>AFRICOS is an ongoing prospective longitudinal cohort study enrolling HIV-infected adults at HIV care centers including sites in Kenya, Tanzania and Uganda. These sites are administered by President's Emergency Plan For AIDS Relief programs.</p><p><strong>Participants: </strong>HIV+ individuals were eligible if they were at least 18 years old, receiving HIV care at the enrolling clinic and consented to data and specimen collection.</p><p><strong>Main outcome measure: </strong>CESD.</p><p><strong>Results: </strong>Among 2307 participants, 18-25% met the CESD threshold for depression. Depression was associated with decreased ARV adherence (OR 0.59, <i>p</i> =  0.01). Higher scores on three CESD items were significantly associated with 209-282% higher viral load, independently of ARV adherence among participants on ARVs ⩾6 months.</p><p><strong>Conclusions: </strong>PLWH had high prevalence of depression on the CESD. Diverse depression symptoms were independently associated with increases in viral load, underscoring the need for comprehensive treatment of depression.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e9"},"PeriodicalIF":3.9,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37385830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}