Depression Treatment Enhances Adherence to Antiretroviral Therapy: a Meta-Analysis

Depression is a risk factor for nonadherence to HIV/AIDS treatment. A meta-analysis was conducted to examine whether treatment of depression and psychological distress improves antiretroviral therapy adherence. PubMed and PsycINFO databases were systematically searched for relevant articles. Studies that reported an association between depression treatment (or an intervention with a component addressing mental health) and antiretroviral adherence were included. Across 29 studies of 12,243 persons living with HIV/AIDS, treatment of depression and psychological distress improved antiretroviral adherence (p < 0.001). The odds of a person adhering were 83 % better if he/she was treated for depression. Greater improvements in adherence were found for samples with lower CD4 counts or more severe depression, for interventions specifically targeting depression (versus addressing mental health as a secondary objective), longer treatments, and observational studies. These findings support the need for detection and treatment of depression among persons living with HIV/AIDS.