Prevalence of Depression Among People Living with HIV on Antiretroviral Therapy in Africa: A Systematic Review and Meta-Analysis.

Background: HIV is a global health issue, with the highest number of infected individuals found in sub-Saharan Africa. The coexistence of HIV with depression is a huge challenge. This study aimed to investigate the prevalence of depression in people living with HIV (PLWHIV) who are on antiretroviral therapy (ART) in Africa.

Method: PubMed, Scopus, and bibliographic screening were used to identify suitable literature. The study adhered to guidelines outlined by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Newcastle-Ottawa guideline was used to assess the quality of the included cross-sectional studies. Subgroup analysis and meta-regression were subsequently conducted following the meta-analyses, based on heterogeneity. A meta-analysis software online tool and Jamovi software (version 2.4.8.0) were used to analyse the data, and the results were presented as prevalence and 95% confidence intervals.

Results: Thirty-four cross-sectional studies identified from the databases were deemed relevant. The overall sample size was 21,143 PLWHIV on ART in African countries. The analysed data showed the prevalence of depression to be 36%, with 95% CI (27% to 40%), < 0.01, in Africa. However, the subgroup showed that the highest prevalence was in Northern Africa, with a prevalence of 41% with 95% CI (20% to 50%), < 0.01, followed by those in Southern and Eastern Africa, with a prevalence of 38% with 95% CI (27% to 49%) and 39% with 95% CI (26% to 50%), < 0.01, respectively. The lowest prevalence was observed in Western Africa, with a prevalence of 20% with 95% CI (14% to 27%), < 0.01.

Conclusions: Our findings show that there is a higher prevalence of depression among PLWHIV who are on ART in Africa. It is crucial to correctly recognise and provide proper care for depression to optimise HIV treatment and enhance treatment adherence in this population.