Changes in depression in a cohort of Danish HIV-positive individuals: time for routine screening

The aim of this study was to follow a cohort of HIV-positive individuals for 3 years in order to assess changes in depression, adherence, unsafe sex and emotional strains from living with HIV.

Participants were assessed for depression, adherence, emotional strain and unsafe sex via a questionnaire. The Beck Depression Inventory II (BDI) was used to assess the prevalence and severity of depressive symptoms. Patients with a BDI score of 20 or above (moderate to major depression) were offered a clinical evaluation by a consultant psychiatrist.

In 2005, 205 HIV-positive individuals participated in the study. Symptoms of depression (BDI >14) were observed in 77 (38%) and major depression (BDI ≥20) in 53 (26%) individuals. In 2008, 148 participants were retested (72% of original sample). Depression (BDI >14) was observed in 38 (26%) and symptoms of major depression (BDI ≥20) in 24 (16%) individuals. Patients at risk of moderate to major depression were more likely to be non-adherent to medications, to practice unsafe sex and to suffer from emotional strains compared with patients not at risk of depression, both at baseline (2005) and follow-up (2008).

This study demonstrated a decline in depression scores over time and an association between the risk of depression and low medication adherence, stress and unsafe sex. We recommend routine screening for depression to be conducted regularly to provide full evaluations and relevant psychiatric treatment.