Depression and HIV: Epidemiological and clinical aspects at the Bamako University Hospital (Mali)

Depression plays an important role in clinical worsening, morbidity and mortality related to HIV/AIDS. Objective: To describe the epidemiological and clinical aspects of depressive disorders in people with HIV in Mali. Methods: This prospective study took place in the department of psychiatry and infectious diseases at the Bamako University Hospital from July 2004 through October, 2005 and included all HIV-positive antiretroviral- naive patients with depression, diagnosed according to ICD-10 criteria. Results: The study included 84 HIV-positive patients with a depressive disorder; our total population of HIV-positive patients was 316 during the study period, for a prevalence rate of 26.7% in this population. The mean age of these depressed patients was 36.7 ± 8.5 years (range: 20-57); 63.1% were women, 47.7% had not attended or at least not completed primary school; 66.6% were married, and 92.9% lived in urban areas. Sad mood, anxiety, and refusal to eat were reported by 27.7%, 10.9%, and 9.1%, respectively, as a reason for consultation. Depression was associated with an anxiety disorder in 33 (39.3%) and a delusional disorder in 14 (16.7%). Severe depression was associated with low BMI and at a CD4 count <200 cells/mm3. Conclusion: Depression was found at a high frequency in our study. Its detection, operational research about it, and improved management are recommended to improve the health of people living with HIV.