Depressive symptoms and adherence to antiretroviral treatment among people with HIV attending a Peruvian public hospital
DOI:
https://doi.org/10.37711/rpcs.2026.8.1.9Keywords:
depression, HIV, treatment adherence, antiretroviral therapy, mental healthAbstract
Objective. To explore the relationship between depressive symptoms and treatment adherence among people with human immunodeficiency virus (HIV) attending a public hospital in Lima, Peru. Methods. A cross-sectional correlational study was conducted. A total of 300 adults diagnosed with HIV participated in the study. Depression was assessed using the Beck Depression Inventory-II (BDI-II), and treatment adherence was assessed using the Questionnaire for the Evaluation of Adherence to Antiretroviral Treatment (CEAT-VIH, by its Spanish acronym). The analysis included descriptive statistics and adjusted multivariate logistic regression analysis. Results. A high prevalence of depressive symptoms was observed, as well as a considerable proportion of participants with inadequate adherence to antiretroviral treatment. No statistically significant differences in treatment adherence were found between participants with moderate and severe depression compared with those with mild depression in the multivariate logistic regression analysis adjusted for age and sex. Conclusions. Although depression was not an independent predictor of adherence, its high frequency highlights the importance of integrating mental health assessment and management into the comprehensive care of people living with HIV.
Downloads
References
1. Zewudie BT, Geze S, Mesfin Y, Argaw M, Abebe H, Mekonnen Z, et al. A systematic review and meta-analysis on depression and associated factors among adult HIV/AIDS-positive patients attending ART clinics of Ethiopia: 2021. Depression Res Treat. [Internet]. 2021 [Consultado el 26 de abril de 2026];2021:1-9. https://doi.org/10.1155/2021/8545934
2. World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach [Internet]. Geneva: World Health Organization; 2021 [Consultado el 8 de mayo de 2026]. Disponible en: https://www.who.int/publications/i/item/9789240031593
3. Arrieta-Martínez JA, Estrada-Acevedo JI, Gómez CA, Madrigal-Cadavid J, Serna JA, Giraldo PA, et al. Factores relacionados con la no adherencia a la terapia antirretroviral en pacientes con VIH/sida. Farm Hosp. [Internet]. 2022 [Consultado el 26 de abril de 2026]. https://dx.doi.org/10.7399/fh.11793
4. Bigna JJ, Tounouga DN, Kenne AM, Djikeussi TK, Foka AJ, Um LN, et al. Epidemiology of depressive disorders in people living with HIV in Africa: a systematic review and meta-analysis. Gen Hosp Psychiatry [Internet]. 2019 [Consultado el 26 de abril de 2026];57:13-22. https://doi.org/10.1016/j.genhosppsych.2018.10.005
5. American Psychiatric Association. Manual diagnóstico y estadístico de los trastornos mentales. Texto Revisado (DSM-5-TR). 5ª ed. Madrid: Editorial Médica Panamericana; 2024.
6. Joint United Nations Programme on HIV/AIDS (UNAIDS). Global HIV & AIDS statistics—fact sheet [Internet]. Ginebra: UNAIDS; 2023 [Consultado el 26 de abril de 2026]. Disponible en: https://www.unaids.org/en/resources/fact-sheet
7. Yang Y, Chen B, Zhang H, Huang P, Qian J, Lin L, et al. Global prevalence of depressive symptoms among people living with HIV/AIDS: a systematic review and meta-analysis of the past five years. AIDS Care [Internet]. 2024 [Consultado el 26 de abril de 2026];36(2):153-164. Disponible en: https://doi.org/10.1080/09540121.2023.2285733
8. Fu J, Chen X, Dai Z, Huang Y, Xiao W, Wang H, et al. HIV-related stigma, depression and suicidal ideation among HIV-positive MSM in China: a moderated mediation model. BMC Public Health [Internet]. 2023 [Consultado el 26 de abril de 2026];23(1):2117. https://doi.org/10.1186/s12889-023-17047-y
9. Remien RH, Patel V, Chibanda D, Abas MA. Integrating mental health into HIV prevention and care: a call to action. J Int AIDS Soc. [Internet]. 2021 [Consultado el 26 de abril de 2026];24(S2):e25748. Disponible en: https://doi.org/10.1002/jia2.25748
10. Nutor JJ, Gyamerah AO, Alhassan RK, Duah HO, Thompson RGA, Wilson N, et al. Influence of depression and interpersonal support on adherence to antiretroviral therapy among people living with HIV. AIDS Res Ther. [Internet]. 2023 [Consultado el 26 de abril de 2026];20:42. https://doi.org/10.1186/s12981-023-00538-8
11. Damulak PP, Ismail S, Abdul Manaf R, Mohd Said S, Agbaji O. Interventions to improve adherence to antiretroviral therapy (ART) in Sub-Saharan Africa: an updated systematic review. Int J Environ Res Public Health [Internet]. 2021 [Consultado el 26 de abril de 2026];18(5):2477. https://doi.org/10.3390/ijerph18052477
12. Ministerio de Salud del Perú. Boletín epidemiológico del VIH/SIDA en el Perú: situación actual 2023 [Internet]. Lima: Ministerio de Salud del Perú; 2023 [Consultado el 26 de abril de 2026]. https://www.dge.gob.pe/portal/docs/vigilancia/vih/
13. Navarro R, Paredes JL, Echevarria J, González-Lagos E, Graña A, Mejía F, et al. HIV and antiretroviral treatment knowledge gaps and psychosocial burden among persons living with HIV in Lima, Peru. PLoS One [Internet]. 2021[Consultado el 26 de abril de 2026];16(8):e0256289. https://doi.org/10.1371/journal.pone.0256289
14. Pan American Health Organization. HIV in Latin America: epidemiological update 2023 [Internet]. Washington (DC): PAHO; 2023 [Consultado el 26 de abril de 2026]. Disponible en: https://www.paho.org/sites/default/files/2023-11/2023-cde-world-aids-day-situation.pdf
15. Creswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods Approaches [Internet]. 5th ed. Los Angeles: SAGE Publications; 2018 [Consultado el 26 de abril de 2026]. https://repository.gctu.edu.gh/items/show/802
16. Katz MH. Multivariable analysis: a practical guide for clinicians and public health researchers. 4th ed. Cambridge: Cambridge University Press; 2011.
17. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio (TX): Psychological Corporation; 1996.
18. Maldonado-Avendaño N, Castro-Osorio R, Cardona-Gómez P. Propiedades psicométricas del Inventario de Depresión de Beck-II (BDI-II) en población universitaria colombiana. Rev Colomb Psiquiatr. [Internet]. 2023 [Consultado el 26 de abril de 2026];52(Supl 1):S51-S59. https://doi.org/10.1016/j.rcp.2021.08.007
19. Sánchez-Villena AR, Farfán Cedrón EF. Análisis factorial exploratorio del Inventario de Depresión de Beck (BDI-II) en universitarios cajamarquinos. Interacciones. [Internet]. 2019 [Consultado el 26 de abril de 2026];5(3):e198. https://doi.org/10.24016/2019.v5n3.198
20. Tafur-Contreras S, Reyes-Barros JA, Ayala-Mendívil RE. Validez y confiabilidad de un instrumento para evaluar el cumplimiento de las funciones de la atención primaria en contexto peruano. Cuidado y Salud Pública [Internet]. 2022 [Consultado el 26 de abril de 2026];2(2):69-74. https://doi.org/10.53684/csp.v2i2.57
21. Remor E. Valoración de la adherencia al tratamiento antirretroviral en pacientes con VIH: desarrollo de un nuevo instrumento. Psicothema. [Internet]. 2002 [Consultado el 26 de abril de 2026];14(3):262-267. Disponible en: https://www.redalyc.org/pdf/727/72714212.pdf
22. Miranda-Chávez B, Mejía-Copaja M, Taype-Rondán A. Adherence to antiretroviral therapy among HIV patients at a hospital in Tacna, Peru. Clin Epidemiol Glob Health [Internet]. 2024 [Consultado el 26 de abril de 2026];30:101803. Disponible en: https://doi.org/10.1016/j.cegh.2024.101803
23. Remor E. Self-reported adherence to antiretroviral therapy in HIV+ Colombian population: psychometric properties of the CEAT-VIH questionnaire. SAGE Open [Internet]. 2013 [Consultado el 26 de abril de 2026];3(3):1-7. https://doi.org/10.1177/2158244013497727
24. World Medical Association. Declaración de Helsinki: principios éticos para las investigaciones médicas con pacientes humanos [Internet]. 2024 [Consultado el 26 de abril de 2026]. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/
25. Vyavaharkar M, Moneyham L, Tavakoli A, Phillips KD, Murdaugh C, Jackson K, et al. Social support, coping, and medication adherence among HIV-positive women with depression living in rural areas of the southeastern United States. AIDS Patient Care STDS. [Internet]. 2007 [Consultado el 26 de abril de 2026];21(9):667-680. https://doi.org/10.1089/apc.2006.0131
26. Mohamad Fisal ZA, Minhat HS, Mohd Zulkefli NA, Ahmad N. Biopsychosocial approach to understanding determinants of depression among men who have sex with men living with HIV: a systematic review. PLoS One [Internet]. 2022 [Consultado el 26 de abril de 2026];17(3):e0264636. Disponible en: https://doi.org/10.1371/journal.pone.0264636
27. Okonji EF, Van Wyk B, Mukumbang FC. Applying the biopsychosocial model to unpack a psychosocial support intervention designed to improve antiretroviral treatment outcomes for adolescents in South Africa. Pan Afr Med J. [Internet]. 2022 [Consultado el 26 de abril de 2026];41:166. https://doi.org/10.11604/pamj.2022.41.166.31985
28. Azuma H, Yeh PT, Kennedy CE, Fonner VA, O'Reilly KR, Sweat MD. Integration of mental health and HIV service delivery in low- and middle-income countries: a systematic review of effectiveness. Glob Ment Health (Camb). [Internet]. 2025 [Consultado el 26 de abril de 2026];12:e112. https://doi.org/10.1017/gmh.2025.10066
29. Oh KS, Lee JS, Kim HC, Kang HY, Lee JY, Han E. Effects of depression on medication adherence in HIV/AIDS patients: Korea HIV/AIDS cohort study. J Infect Public Health [Internet]. 2023 [Consultado el 26 de abril de 2026];16(10):1598-1605. https://doi.org/10.1016/j.jiph.2023.07.018
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Jesus Yandir Hernández-Aparcana
This work is licensed under a Creative Commons Attribution 4.0 International License.
