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. 2023 Jul;27(7):2070-2078.
doi: 10.1007/s10461-022-03939-4. Epub 2022 Dec 6.

Age-varying Associations of Depressive Symptoms and Heavy Episodic Drinking Throughout Adulthood Among People with HIV and Receiving care in Cameroon Within a National "treat all" Policy

Kathryn Elizabeth Lancaster  1 , Molly Remch  2 , Andrew Edmonds  2 , Rogers Ajeh  3 , Anastase Dzudie  3 , Adebola Adedimeji  4 , Denis Nash  5 , Kathryn Anastos  6 , Marcel Yotebieng  4 , Eric Walter Yone-Pefura  7 , Denis Nsame  8 , Angela M Parcesepe  2
Affiliations

Age-varying Associations of Depressive Symptoms and Heavy Episodic Drinking Throughout Adulthood Among People with HIV and Receiving care in Cameroon Within a National "treat all" Policy

Kathryn Elizabeth Lancaster et al. AIDS Behav. 2023 Jul.

Abstract

Comorbid depression and heavy episodic drinking (HED) may threaten the success of "treat all" policies in sub-Saharan Africa as the population of people with HIV (PWH) ages. We investigated associations between depressive symptoms and heavy episodic drinking (HED) and the extent the relationship differed across ages among PWH receiving HIV care in Cameroon. We conducted a retrospective analysis of 18-60-year-old PWH on antiretroviral therapy in Cameroon from January 2016 to March 2020. Age-varying effect modelling was conducted to assess associations between depressive symptoms and HED across ages and by gender. Prevalence of depression and HED was highest at ages 20 and 25, respectively. After age 25, the magnitude of the association between depressive symptoms and HED was significant and increased until age 30 (aOR: 1.88, 95% CI: 1.48, 2.39), with associations remaining significant until age 55 (aOR: 1.64, 95% CI: 1.17, 2.29). Women had more variability and higher magnitudes of associations between depressive symptoms and HED than men. The interrelationship between depressive symptoms and HED was significant throughout most of adulthood for PWH receiving HIV care in Cameroon. Understanding age and gender trends in these associations can guide integration efforts in HIV care settings.

Keywords: Adults; Alcohol misuse; Antiretroviral therapy; Cameroon; HIV; Mental health.

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Figures

Fig. 1
Fig. 1
Participant inclusion flowchart
Fig. 2
Fig. 2. Prevalence of depressive symptoms (A) and heavy episodic drinking (B) among people with HIV ages 18 to 60 (x-axis) and on antiretroviral treatment in Cameroon, 2016–2020.
Solid line represents probability estimates; dashed lines represent 95% confidence intervals
Fig. 3
Fig. 3
Time-varying effect modeling showing the association between depressive symptoms and heavy episodic drinking across the age range (18 to 60 years) among adults ages 18 to 60 living with HIV and on anti-retroviral treatment in Cameroon, 2016–2020
Fig. 4
Fig. 4. Time-varying effect modeling showing the association between depressive symptoms and heavy episodic drinking among men (A) and women (B), ages 18 to 60 on antiretroviral treatment living with HIV in Cameroon, 2016–2020.
The solid line represents the adjusted odds ratio of the effect of depressive symptoms on heavy episodic drinking, and the dashed line represents the corresponding 95% confidence interval. Odds ratio adjusted on the y-axis for the time-invariant effects of clinic site, smoking, HIV status disclosure, and education
See this image and copyright information in PMC

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