Severity and Associated Factors of Depression among People Living with HIV/AIDS in the Bamenda Municipality, Cameroon

Abstract

Background: Depression is an important mental health comorbidity among people living with HIV/AIDS (PLWHA), yet evidence describing its severity, diagnostic subtypes, symptom patterns, and associated factors in Bamenda Municipality remains limited. Aims: To assess the prevalence, severity, depressive disorder subtypes, commonly reported symptoms, and associated factors of depression among adults living with HIV/AIDS in Bamenda Municipality, Cameroon. Study Design: Facility-based cross-sectional study. Place and Duration of Study: Four HIV treatment centres in Bamenda Municipality, Cameroon, over a period of two years. Methodology: A total of 1,068 adults living with HIV/AIDS were recruited using a three-stage sampling procedure. Four HIV treatment centres were purposively selected based on patient volume and service capacity. The sample size was proportionally allocated across facilities, and eligible adults were consecutively recruited until the required sample size was attained. Depression was assessed using the Hamilton Depression Rating Scale (HAM-D) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Data were analysed using descriptive and multivariable logistic regression analyses. Statistical significance was set at p < 0.05. Results: The prevalence of depression was 37.8% (404/1,068). Mild depression was the most common severity category (57.7%, n = 233), followed by moderate depression (17.1%, n = 69). Among the 404 depressed participants, Major Depressive Disorder accounted for 37.1% (n = 150), Unspecified Depressive Disorder for 35.4% (n = 143), and Persistent Depressive Disorder for 27.5% (n = 111). Significant factors associated with depression included male gender (AOR = 2.224, 95% CI: 1.512-3.270, p = 0.001), being divorced (AOR = 7.722, 95% CI: 2.001-14.890, p = 0.006), longer duration of HIV infection (AOR = 1.145, 95% CI: 1.021-1.285, p < 0.05), lower educational attainment (AOR = 1.876, 95% CI: 1.210-2.905, p < 0.05), higher HIV-related stigma (AOR = 1.320, 95% CI: 1.180-1.480, p < 0.001), lower social support (AOR = 0.812, 95% CI: 0.701-0.940, p < 0.001), and self-harm behaviour (AOR = 2.218, 95% CI: 1.889-2.606, p < 0.001). Conclusion: Depression was common among people living with HIV/AIDS in Bamenda Municipality. Mild depression predominated, while Major Depressive Disorder was the most frequent diagnostic subtype. Routine depression screening, stigma reduction strategies, and strengthened psychosocial support should be integrated into HIV care services.