Depression care in Kenya has limited access due to a shortage of specialists and inadequate finances for mental health services. This study aimed to determine the prevalence and barriers to accessing depression care among people living with HIV in Juja Sub-County, Kiambu County, Kenya.
Methods
A quantitative analytical cross-sectional study was used. A total of 329 people living with HIV receiving comprehensive care at six public health facilities in Juja Sub-County were selected using a stratified sampling technique. Data were collected using interviewer-administered questionnaires after obtaining informed consent from each study participant. The prevalence of depression was assessed using the PHQ-9 scale. Data analysis was done using R. Descriptive statistics were computed. An ordinal logistic regression model was used to determine the factors associated with the prevalence of depression. A binary logistic regression model was used to determine the individual barriers to accessing depression care. Adjusted odds ratios (AORs) with a 95% confidence interval were used to measure the association, and a p-value of less than 0.05 was considered statistically significant.
Results
The prevalence of depression was 27.4% (95% CI: 22.7–32.6), and 84.4% of affected participants did not access depression care. Depression was significantly associated with poor adherence to HIV medication (AOR = 2.42; 95% CI: 1.53–3.85), poor social support (AOR = 0.57, 95% CI: 0.33–0.99), and high perceived HIV stigma (AOR = 1.85; 95% CI: 1.18–2.93). Additionally, poor adherence to HIV medication (AOR = 0.21; 95% CI: 0.04–0.76) emerged as a significant barrier to accessing depression care.
Conclusions
A severe treatment gap exists, with 84.4% of depressed people living with HIV not receiving needed care despite a high depression prevalence of 27.4%.
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