Knowledge of HIV status is associated with a decrease in the severity of depressive symptoms among female sex workers in Uganda and Zambia

Background: - Knowledge of HIV-positive status may result in depressive symptoms, which may be a concern to scaling novel HIV testing interventions that move testing outside the health system and away from counselor support. - Setting: - Uganda and Zambia. - Methods...

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Main Authors: Ortblad, Katrina (Author) , Musoke, Daniel Kibuuka (Author) , Chanda, Michael M. (Author) , Ngabirano, Thomson (Author) , Velloza, Jennifer (Author) , Haberer, Jessica E. (Author) , McConnell, Margaret A. (Author) , Oldenburg, Catherine E. (Author) , Bärnighausen, Till (Author)
Format: Article (Journal)
Language:English
Published: January 1, 2020
In: Journal of acquired immune deficiency syndromes
Year: 2020, Volume: 83, Issue: 1, Pages: 37-46
ISSN:1944-7884
DOI:10.1097/QAI.0000000000002224
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/QAI.0000000000002224
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/jaids/Fulltext/2020/01010/Knowledge_of_HIV_Status_Is_Associated_With_a.6.aspx
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Author Notes:Katrina F. Ortblad, Daniel Kibuuka Musoke, Michael M. Chanda, Thomson Ngabirano, Jennifer Velloza, Jessica E. Haberer, Margaret McConnell, Catherine E. Oldenburg and Till Bärnighausen

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520 |a Background: - Knowledge of HIV-positive status may result in depressive symptoms, which may be a concern to scaling novel HIV testing interventions that move testing outside the health system and away from counselor support. - Setting: - Uganda and Zambia. - Methods: - We used longitudinal data from 2 female sex worker (FSW) cohorts in Uganda (n = 960) and Zambia (n = 965). Over 4 months, participants had ample opportunity to HIV testing using standard-of-care services or self-tests. At baseline and 4 months, we measured participants' perceived knowledge of HIV status, severity of depressive symptoms (continuous PHQ-9 scale, 0-27 points), and prevalence of likely depression (PHQ-9 scores ≥10). We estimated associations using individual fixed-effects estimation. - Results: - Compared with unknown HIV status, knowledge of HIV-negative status was significantly associated with a decrease in depressive symptoms of 1.06 points in Uganda (95% CI −1.79 to −0.34) and 1.68 points in Zambia (95% CI −2.70 to −0.62). Knowledge of HIV-positive status was significantly associated with a decrease in depressive symptoms of 1.01 points in Uganda (95% CI −1.82 to −0.20) and 1.98 points in Zambia (95% CI −3.09 to −0.88). The prevalence of likely depression was not associated with knowledge of HIV status in Uganda but was associated with a 14.1% decrease with knowledge of HIV-negative status (95% CI −22.1% to −6.0%) and a 14.3% decrease with knowledge of HIV-positive status (95% CI −23.9% to −4.5%) in Zambia. - Conclusions: - Knowledge of HIV status, be it positive or negative, was significantly associated with a decrease in depressive symptoms in 2 FSW populations. The expansion of HIV testing programs may have mental health benefits for FSWs. 
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