Prevalence and associated factors of ICD/DSM-diagnosed depressive disorders among people living with HIV: A systematic review and meta-analysis.

BACKGROUND

Depressive disorders are highly prevalent among people living with HIV (PLWH), severely impairing quality of life and antiretroviral therapy (ART) adherence. While ART advances call for reassessing depressive disorders among PLWH prevalence, most studies rely on self-report tools rather than standardized clinical diagnoses. Linked to HIV stigma, low CD4+ T-cell counts, and ART-related side effects, depressive disorders among PLWH requires targeted prevention and intervention strategies.

METHODS

An extensive search was conducted across PubMed, Web of Science, and Embase databases up to 30 June 2025 to identify relevant studies. After selecting the appropriate studies that depressive disorders were confirmed through ICD/DSM criteria, a random-effects meta-analysis was performed to estimate the incidence of depressive disorders among PLWH using the event rate. Additionally, we conducted subgroup meta-analyses to explore any discrepancies among different groups. The Joanna Briggs Institute's Quality Assessment Checklist was utilized to evaluate the quality of the included studies. We employed I2 and Q-tests to assess both the magnitude and statistical significance of heterogeneity.

RESULTS

The final analysis includes 15 studies with sample sizes ranging from 60 to 124,766. The estimated prevalence of depressive disorders among PLWH was 23.2% (95% CI 14.9-34.2). Significant factors associated with depressive disorders among PLWH were race, alcohol abuse, higher baseline and current CD4+ T-cell count, and longer HIV diagnosis duration (time from HIV diagnosis to depressive disorders diagnosis) (P ≤ 0.001).

CONCLUSIONS

Depressive disorders are significantly more prevalent among PLWH than in the general population, with potential associations with race, CD4+ T-cell counts, HIV infection duration, and alcohol misuse.