Abstract
This meta-analytic review evaluated the effectiveness of depression interventions on the psychological and immunological outcomes of people living with HIV in sub-Saharan Africa. 14 studies, yielding 932 participants were eligible. A random-effects models indicated that depression interventions were followed by large reductions in depression scores (effect size = 1.86, 95% CI = 1.71, 2.01, p < 0.01). No significant effect on immune outcome was observed, however there was a trend toward immune improvement of medium effect size (effect size on CD4 count and/or viral suppression = 0.57, 95% CI = −0.06, 1.20, p = 0.08). Pharmacological interventions appeared to have a significantly larger improvement in depression scores than psychological interventions. The greatest improvement in immune status was demonstrated in psychological treatments which incorporated a component to enhance HIV medication adherence, however these results did not reach significance. Small sample sizes and highly heterogeneous analysis necessitate caution in interpretation. The results of this meta-analysis should thus be treated as preliminary evidence and used to encourage further studies of immunopsychiatry in HIV in sub-Saharan Africa.
| Original language | English |
|---|---|
| Journal | Brain, Behavior, and Immunity |
| Early online date | 13 May 2018 |
| DOIs | |
| Publication status | E-pub ahead of print - 13 May 2018 |
Keywords
- CD4
- Depression
- HIV/AIDS
- Immunopsychiatry
- Intervention
- Meta-analysis
- Psychoneuroimmunology
- Review
- Sub-Saharan Africa
- Viral load
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