Counselling and depressive symptoms in older adults with HIV/AIDS in mbarara, Uganda

Abstract

Background: Depression is a mood disorder characterized by persistent low mood, loss of interest, hopelessness, sleep disturbances, difficulty concentrating, and low self-esteem. Among people living with HIV (PLWH), depression is linked to poor psychological and medical outcomes, including lower quality of life, higher viral load, and increased mortality risk. Various psychotherapy methods, such as cognitive behavioral therapy (CBT), interpersonal psychotherapy, group counselling, and rational emotive behavior therapy (REBT), have been used to treat depression. Counselling, an interpersonal process between a client and a counselor, has been shown to reduce stress, anxiety, and hopelessness among PLWH. This study assessed the role of counselling on reducing depressive symptoms in older adults with HIV/AIDS in Mbarara, Uganda. Methods: We recruited 265 older adults (mean age 64.2±5.1 years; 150 women, 115 men) receiving HIV/ AIDS services at four care centers. The Patient Health Questionnaire assessed depression levels, while additional questionnaires evaluated the frequency and perceived benefits of counselling. Reported benefits included improved self-esteem, better illness management, reduced stigma, increased medication adherence, and financial empowerment. Logistic regression was used to analyze the relationship between counselling and depression, with a significance level set at 5%. We used stepwise logistic regression to select the final model, with a p-value threshold of 0.05 for variable inclusion and p-value of 0.10 for variable retention. Findings: Most participants (216; 83.4%) reported that counselling helped them cope with their illness, reducing their likelihood of depression. Factors associated with counselling and depression included lack of home visits (AOR=2.54, 95% CI 1.57–13.07, p=0.019) and infrequent counselor interactions (AOR=1.24, 95% CI 1.09–3.84, p=0.014). Conclusion: Regular home visits and counselling are associated with significant reductions in depressive symptoms among older adults living with HIV/AIDS. Incorporating home-based counselling services and regular home visits can enhance the well-being of this population.