Despite the substantial burden of HIV in Africa, and the knowledge that depression causes worse HIV outcomes, the burden of depression in people living with HIV in Africa is unknown. We searched Pubmed and four other databases using key terms: depression, Africa, HIV, and prevalence from 2008 to 2018. We summarized depression prevalence by country. We estimated the burden of depression using our prevalence data and 2018 UNAIDS HIV estimates. Our search yielded 70 articles across 16 African countries. The overall prevalence of major depression in those HIV-infected using a diagnostic interview was 15.3% (95% CI 12.5–17.1%). We estimate that 3.63 million (99.7% CI 3.15–4.19 million) individuals with HIV in Sub-Saharan Africa have major depression and provide country-level estimates. We estimate that 1.57 million (99.7% CI 1.37–1.82 million) DALYs are lost among people with depression and HIV in Sub-Saharan Africa. There is a significant burden of depression in Africans with HIV. Further work to screen for and treat depression in Sub-Saharan Africa is needed to improve HIV outcomes and achieve the 90-90-90 UNAIDS goals.
Bibliographical noteFunding Information:
This research was supported by the National Institute of Neurologic Diseases and Stroke (NINDS), Fogarty International Center (R01NS086312, R25TW009345), the National Institute of Allergy and Infectious Diseases (T32AI055433), and the National Institute of Mental Health (K23 MH121220). We thank Jose Debes for his kind help in translating our abstract into Spanish.
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- Burden of disease
- Sub-Saharan Africa