Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda

Partners Demonstration Project Team

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. We followed 1013 HIV-infected individuals participating in the Partners Demonstration Project, an open-label study of integrated pre-exposure prophylaxis (PrEP) and ART delivery for HIV serodiscordant couples in Kenya and Uganda. Associations between depression, measured annually with the Hopkins Symptoms Checklist-Depression (HSCL-D), and ART initiation were assessed with Cox proportional hazards regression. At enrollment, 162 participants (16.0%) reported symptoms consistent with probable depression, defined by a HSCL-D mean score >1.75, and this proportion decreased during study follow-up (6.7 and 3.6% at 12- and 24-months, respectively; p value < 0.001). Greater depressive symptom severity was associated with a greater likelihood of ART initiation overall (adjusted hazard ratio [aHR] 1.32, 95% CI 1.01–1.73) and among participants with CD4 count ≤ 350 cells/µl (aHR 1.30, 95% CI 1.01–1.67). Depression decreased 6 months after ART initiation (adjusted odds ratio [aOR] 0.34, 95% CI 0.23–0.51). Among East African HIV-infected persons in HIV serodiscordant couples, depression was not a barrier to ART initiation. ART initiation was associated with improved depressive symptoms in this setting.

Original languageEnglish (US)
Pages (from-to)2509-2518
Number of pages10
JournalAIDS and behavior
Issue number8
StatePublished - Aug 1 2017


  • Africa
  • Antiretroviral therapy initiation
  • Depression
  • HIV

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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