The longitudinal change of depressive symptoms among people living with HIV in Guangdong Province, China: A network analysis.

BACKGROUND

Depression may change over time among people living with HIV (PLHIV). This study aimed to understand longitudinal change of depression among PLHIV in China, and the impact of change in depression on mortality.

METHODS

A cohort study was conducted to collect data on depressive symptoms among PLHIV at baseline and one-year follow-up in Guangdong Province from May 2018 to June 2019 and continued to follow up until June 2023. Generalized estimating equations were used to explore factors associated with depression. Network analysis was used to explore the interrelations between specific depressive symptoms at baseline and one-year follow-up.

RESULTS

30.9 % of 792 participants had a pattern of remission at one-year follow-up, 6.3 % had persistent depression at both baseline and one-year follow-up, and 5.9 % had new-onset depression at one-year follow-up. 46 (5.8 %) participants died. High levels of education, HIV-related symptoms, high levels of HIV-related stigma, and low social cohesion were longitudinally associated with a higher risk of depression. Network analysis revealed that "Depressed mood" and "Sadness" had high centrality in both the baseline and follow-up networks, with "Fearful" being the most increased central node at follow-up compared to baseline. Cox regression after propensity score weighting showed that the groups with new-onset and persistent depression had a higher risk of mortality than the non-depressed group.

CONCLUSION

More attention should be paid to individuals with high levels of education and those with HIV-related symptoms. Interventions targeting symptoms with increased centrality nodes, reducing HIV-related stigma and improving social cohesion may also help to reduce depression among PLHIV.