Depression and Its Correlates among People Living with Human Immunodeficiency Virus at St. Paul’s Hospital Millennium Medical College, Addis Ababa, 2026

Abstract

Abstract Background: Depressive symptoms (DS) are common among people living with HIV (PLWH) and are associated with poor adherence to antiretroviral therapy, reduced quality of life, and increased morbidity. In Ethiopia, prevalence estimates range from 36% to 39%. Although some studies have examined depression in other populations at St. Paul’s Hospital Millennium Medical College (SPHMMC), no recent hospital-based study assessed the prevalence and correlates of DS among PLWH attending ART services at this major urban referral center. Without this evidence, clinicians lack the data needed to identify high-risk patients, hindering targeted interventions and potentially perpetuating poor ART adherence and adverse health outcomes. Objective: This study assessed the prevalence of depressive symptoms and associated factors among PLWH at the ART clinic of SPHMMC. Methods: A facility-based cross-sectional study was conducted among 408 adults living with HIV attending the ART clinic at SPHMMC from 19 September to 21 November 2025. Participants were selected using consecutive sampling. Depressive symptoms were measured using the validated Amharic PHQ-9 (score ≥10 indicating clinically significant symptoms). Psychosocial factors were assessed with the Oslo Social Support Scale (OSSS-3) and a locally adapted HIV-related stigma questionnaire. Clinical data, including CD4 count, WHO stage, and ART regimen, were extracted from medical records. Binary logistic regression identified factors associated with depressive symptoms (p <0.05). Ethical clearance was obtained from the SPHMMC Institutional Review Board. Results: Among the 408 participants, 59.1% had clinically significant depressive symptoms (PHQ-9 ≥10). Poor social support was the strongest predictor, with participants in Oslo category 1 having nearly nine times higher odds (AOR = 8.97, 95% CI: 1.72–46.79, p = 0.009) and those in category 2 having over eleven times higher odds (AOR = 11.17, 95% CI: 2.09–59.75, p = 0.005) compared to those with strong support. Higher HIV-related stigma doubled the odds of depression (AOR = 1.99, 95% CI: 1.23–3.22, p = 0.005), and tobacco use was also significantly associated (AOR = 3.39, 95% CI: 1.08–10.61, p = 0.036). Demographic and clinical variables, including age, education, residence, WHO stage, and comorbidities, were not significantly associated. Conclusion: This high prevalence underscores the urgent need to integrate routine mental health screening into HIV care at urban referral centers in Ethiopia. Keywords: Depressive Symptoms, HIV, Prevalence, Correlates, Cross-Sectional Study, Ethiopia