The Effect of Poor Social Support on Depression among HIV/AIDS Patients in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background. Low- and middle-income countries of which Ethiopia is one bears the high burden of depression among human immune deficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients. Several factors have been identified as being associated with increased depression among HIV/AIDS patients including poor social support. However, studies examining the effect of poor social support on depression among HIV/AIDS patients in Ethiopia have had inconsistent findings. This systematic review and meta-analysis is therefore aimed at estimating the pooled effect of poor social support on depression among HIV/AIDS patients in Ethiopia. Methods. All relevant articles published prior to July 1, 2020, were retrieved from scientific databases: PubMed, Scopus, and Google Scholar systematically. The identified studies reporting the association of depression and poor social support among HIV patients in Ethiopia were included. $I^2$ tests were used to assess the heterogeneity of the studies. Subgroup analysis was done based on tools to determine how pooled estimates of depression vary across tools. The pooled estimate of association between poor social support and depression was reported. Results. The aggregated meta-analysis revealed a higher odds of depression among patients with poor social support than those who had strong social support (OR: 2.31, 95% CI: 1.69, 2.93). The pooled prevalence of depression among HIV/AIDS patients in Ethiopia was 38.93% (95%: CI: 32.01, 45.84); ( $I^2=94.44$ %, $p\le 0.001$ ). The subgroup analysis was performed based on tools, and the result showed that the highest pooled prevalence (44.42%) was among primary studies that used the Hospital Anxiety and Depression Scale (HADS) tool. Conclusions. Human immune deficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients with poor social support were more likely to develop depression. The pooled prevalence of depression among HIV/AIDS patient was high in Ethiopia. The highest prevalence of depression was observed among studies that used HADS to screen depression. Therefore, we recommend integration of mental health and psychosocial support services into the HIV/AIDS care. Prevention of HIV/AIDS-related stigma for people with HIV/AIDS is also needed to reduce the impact of poor social support.