Impact of Depression and Anxiety on Antiretroviral Therapy Initiation and Adherence among Newly Diagnosed HIV-infected Men Who Have Sex with Men in China

Abstract

This dissertation explored the effects of depression and anxiety on antiretroviral therapy (ART) initiation and adherence among newly diagnosed HIV-infected Chinese men who have sex with men (MSM). First, I conducted a meta-analysis on depression and ART use, and found that depression was associated with no ART use among people living with HIV (PLHIV). As little is known among the effect of depression and anxiety on ART initiation among newly diagnosed HIV-infected population, I explore their effects in a prospective study, and found a counterintuitive result that depression and anxiety can promote ART initiation among newly diagnosed HIV-infected Chinese MSM. Depression and anxiety are associated with poor ART adherence among PLHIV, I test their negative effect on ART adherence in newly diagnosed Chinese MSM. The result was concordant with the finding among PLHIV. Depression and anxiety is common among Chinese MSM. Alternative intervention is needed for depression and anxiety intervention. I tested the effect of peer counseling on the reduction of depression and anxiety among newly diagnosed HIV-infected Chinese MSM during 12-months of follow-up. The result did not show a significant reduction on both score and prevalence of depression and anxiety over 12-months of follow-up. Depression and anxiety are critical issues among Chinese MSM with newly diagnosed HIV infections. Interventions on depression and anxiety can have an impact on increasing the rate of HIV testing and linkage-to-care, and contribute much to curb the HIV epidemic in China. The study findings can provide information for interventions targeted depression and anxiety after HIV diagnosis.