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AIDS Care. 2017 Mar;29(3):299-305. doi: 10.1080/09540121.2016.1201194. Epub 2016 Aug 10.

Depression and anxiety were low amongst virally suppressed, long-term treated HIV-infected individuals enrolled in a public sector antiretroviral program in Thailand.

Author information

a Department of Disease Control, Ministry of Public Health , Bamrasnaradura Infectious Disease Institute , Nonthaburi , Thailand.
b Faculty of Social Sciences and Humanities , Mahidol University , Nakornpathom , Thailand.
c HIV-NAT , Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
d Sanpatong Hospital , Chiang Mai , Thailand.
e Division of Allergy and Immunology, Faculty of Medicine , Chulalongkorn University , Bangkok , Thailand.
f US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD , Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda , MD , USA.


HIV/AIDS and anxiety/depression are interlinked. HIV-infected patients suffering from depression may be at risk for poor adherence which may contribute to HIV disease progression. Additionally, an HIV diagnosis and/or using certain antiretroviral agents may trigger symptoms of anxiety/depression. The objective of the study was to assess the prevalence and factors associated with anxiety and depression in HIV-infected patients from the Thai National HIV Treatment Program. This cross-sectional study was performed from January 2012 to December 2012 in HIV-infected out-patients, aged ≥18 years, from three HIV referral centers. Symptoms of anxiety and depression were measured using the Thai-validated Hospital Anxiety and Depression Scale (HADS). A score of ≥11 was defined as having anxiety and depression. Associated factors were assessed by multivariate logistic regression. Totally 2023 (56% males) patients were enrolled. All patients received antiretroviral therapy (ART) for a mean duration of 7.7 years. Median CD4 was 495 cells/mm3. Ninety-five percent had HIV-RNA < 50 copies/ml. Thirty-three percent were currently on efavirenz (EFV)-based ART. The prevalence of anxiety and depression were 4.8% and 3.1%, respectively. About 1.3% had both anxiety and depression. In multivariate logistic models, the female sex [OR = 1.6(95%CI 1.1-2.3), p = .01], having adherence <90% [OR = 2.2(95%CI 1.5-3.4), p < .001], fair/poor quality of life (QOL) [OR = 7.2 (95%CI 3.6-14.2), p < .001] and EFV exposure [OR = 1.6(95%CI 1.1-2.3), p = .01], were independently associated with having anxiety or depression. Our findings demonstrated that prevalence of depression and anxiety was low amongst virally suppressed, long-term antiretroviral-treated HIV-infected individuals. Some key characteristics such as the female sex, poor adherence, poor/fair QOL and EFV exposure are associated with anxiety and depression. These factors can be used to distinguish who would need a more in-depth evaluation for these psychiatric disorders.


Depression; HIV-1 infected patients; Thailand; anxiety; efavarenz; female

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