***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Depression is associated with increased HIV transmission risk , increased morbidity , and higher risk of HIV-related death among HIV-infected women . Low sexual relationship power also contributes to HIV risk , but there is limited underst and ing of how it relates to mental health among HIV-infected women . Methods Participants were 270 HIV-infected women from the Ug and a AIDS Rural Treatment Outcomes study , a prospect i ve cohort of individuals initiating antiretroviral therapy ( ART ) in Mbarara , Ug and a. Our primary predictor was baseline sexual relationship power as measured by the  Sexual Relationship Power Scale ( SRPS )  . The primary outcome was depression severity , measured with the Hopkins Symptom Checklist ( HSCL )  , and a secondary outcome was a functional scale for mental health status ( MHS ) . Adjusted models controlled for socio-demographic factors , CD4 count , alcohol and tobacco use , baseline WHO stage 4 disease , social support , and duration of ART . Results The mean HSCL score was 1.34 and 23.7 % of participants had HSCL scores consistent with probable depression ( HSCL>1.75 ) . Compared to participants with low SRPS scores , individuals with both moderate ( coefficient b = −0.21 ; 95%CI , −0.36 to −0.07 ) and high power ( b = −0.21 ; 95%CI , −0.36 to −0.06 ) reported decreased depressive symptomology . High SRPS scores halved the likelihood of women meeting criteria for probable depression ( adjusted odds ratio = 0.44 ; 95%CI , 0.20 to 0.93 ) . In lagged models , low SRPS predicted subsequent depression severity , but depression did not predict subsequent changes in SPRS . Results were similar for MHS , with lagged models showing SRPS predicts subsequent mental health , but not visa versa . Both Decision-Making Dominance and Relationship Control subscales of SRPS were associated with depression symptom severity . Conclusions HIV-infected women with high sexual relationship power had lower depression and higher mental health status than women with low power . Interventions to improve equity in decision-making and control within dyadic partnerships are critical to prevent HIV transmission and to optimize mental health of HIV-infected women Major  depressive disorder in HIV-positive persons is often not diagnosed , and poorly treated . The effect of depression screening on case detection , and rates of antidepressant prescription is unknown . We assessed 368 participants for major depressive disorder , and provided clinicians with the results . Four weeks later , we abstract ed information from the charts of the depressed patients to ascertain if they received antidepressants . We also r and omly sample d the charts of 368 non-screened patients , to ascertain whether clinicians had diagnosed and prescribed antidepressant treatment . Major depressive disorder was identified in 17.9 % of the screened group , and in 2.1 % of the non-screened group [ OR = 9.65 , CI = ( 4.54–20.50 ) ] . The screened individuals were 7.8 times more likely to receive antidepressants  ( 95 % CI = 3.04–20.24 ) . Identification of major depressive disorder by clinicians in HIV setting s remains poor . However , routine screening can improve case detection rates and the proportion of patients receiving antidepressants Purpose We examined the effect of antiretroviral therapy ( ART ) , and the predictive role of depression , on condom use with primary partners . Methods Data from three studies in Ug and a were combined into a sample of 750 patients with a primary sex partner , with 502 starting ART and 248 entering HIV care , and followed for 12 months . R and om-effects logistic regression models were used to examine the impact of ART , and the influence of baseline level and change in depression , on condom use with primary partners . Results At month 12 , 61 % ART and 67 % non-ART patients were consistent condom users , compared to 44 and 41 % at baseline , respectively . Multivariate analysis revealed that consistent condom use increased similarly for ART and non-ART patients , and that minor depression at baseline and increased depression over time predicted inconsistent condom use . Conclusions Improved depression diagnosis and treatment could benefit HIV prevention OBJECTIVES Depression is common among persons living with HIV/AIDS in sub-Saharan Africa , yet few studies in the region have assessed the relationship of depression to economic well-being and risk-reduction behavior . Among HIV clients in Ug and a , we examined whether depression is directly related to self-efficacy , work status , and condom use , as well as indirectly through its interaction with physical health functioning . METHODS Baseline data from a prospect i ve longitudinal cohort of 602 clients entering HIV care were examined . In separate multivariate analyses , we examined whether depression [ both depressive severity and clinical depression , as measured by the nine-item Patient Health Question naire ( PHQ-9 ) ] , physical health functioning , and their interaction were predictors of current work status , consistent condom use , and general self-efficacy , controlling for measures of social support , stigma , and demographics . RESULTS Mean PHQ-9 score was 5.2 ( S.D.=3.9 ; range=0 - 24 ) and 13 % had scores ≥10 ( indicator of clinical depression ) . Not being depressed , better physical health , and their interaction were predictors of working , while lower depressive severity , lower physical health , and their interaction were associated with always using condoms . Better physical health was predictive of greater self-efficacy , but not depression ; general self-efficacy was predictive of both work status and condom use . CONCLUSIONS Effective diagnosis and treatment of depression may be critical to maximizing the benefits of HIV treatment with regard to both HIV prevention and restoring the social and economic health of persons living with HIV Depressive symptoms have been shown to independently affect both antiretroviral therapy ( ART ) adherence and HIV clinical outcomes in high-income countries . We examined the prospect i ve relationship between depressive symptoms and adherence , virologic failure , and suppressed immune function in people living with HIV/AIDS in Tanzania . Data from 403 study participants who were on stable ART and engaged in HIV clinical care were analyzed . We assessed crude and adjusted associations of depressive symptoms and ART adherence , both at baseline and at 12 months , using logistic regression . We used logistic generalized estimating equations to assess the association and 95 % confidence intervals ( CI ) between depressive symptoms and both virologic failure and suppressed immune function . Ten percent of participants reported moderate or severe depressive symptoms at baseline and 31 % of participants experienced virologic failure ( > 150 copies/ml ) over two years . Depressive symptoms were associated with greater odds of reported medication nonadherence at both baseline ( Odds Ratio [ OR ] per 1-unit increase = 1.18 , 95 % CI [ 1.12 , 1.24 ] ) and 12 months ( OR = 1.08 , 95 % CI [ 1.03 , 1.14 ] ) . By contrast , increases in depressive symptom score were inversely related to both virologic failure ( OR = 0.93 , 95 % CI [ 0.87 , 1.00 ] ) and immune system suppression ( OR = 0.88 , 95 % CI [ 0.79 , 0.99 ] ) , though the association between depressive symptoms and clinical outcomes was less precise than for the association with nonadherence . Findings indicate a positive association between depressive symptoms and nonadherence , and also an inverse relationship between depressive symptoms and clinical outcomes , possibly due to informative loss to follow-up BACKGROUND Psychiatric disorders in HIV/AIDS are common , emerging soon after diagnosis or during the subsequent course of illness . However , there are few prospect i ve studies on the rates of psychiatric disorders in HIV/AIDS , particularly in the context of the developing world . METHODS Sixty-five patients with recently diagnosed HIV were interviewed on presentation to a hospital-based HIV clinic and then 6 months later . On both interviews , the patients were assessed using the  MINI International Neuropsychiatric Interview , the Carver Brief COPE , and the Sheehan Disability Scale . Exposure to negative life events and risk behaviors  was also evaluated . RESULTS The overall prevalence of psychiatric disorders in the follow-up period remained high ( 56 % of patients had at least one psychiatric disorder at baseline , and 48 % of patients had at least one psychiatric disorder at 6 months ) . Depression and posttraumatic stress disorder ( PTSD ) were the most prevalent disorders at both baseline ( 34.9 % and 14.8 % ) and follow-up ( 26 % and 20 % ) , respectively . More than half of all patients with depression at baseline improved ( 16 of 29 ; 55.1 % ) . However , there was a new onset of both depression ( 4 of 49 ; 8.1 % ) and PTSD ( 12 of 17 ; 70.5 % ) on follow-up . In univariate analysis , depression on follow-up was significantly associated with : ( a ) disability in work/social/family functioning , ( b ) greater number of negative life events , and ( c ) a decline in CD4 lymphocyte count . Univariate analysis also revealed that a diagnosis of PTSD on follow-up was significantly associated with ( a ) a longer duration of infection and ( b ) baseline disability in work/social/family functioning . However , in multivariate analysis , only disability scores predicted the diagnoses of major depression and PTSD on follow-up assessment . Persistence of risky sexual behaviour was also noted , with a significantly higher number of participants reporting nonuse of condom on follow-up . There appeared to be a shift from maladaptive coping behaviors to more adaptive coping behaviors over the 6-month period . CONCLUSION The rate of psychiatric disorders in HIV/AIDS patients was consistent over time . These findings emphasize the importance of regular evaluation for psychiatric disorders in HIV/AIDS patients , not only at the commencement of treatment but also during subsequent follow-up visits Background The devastating impact of AIDS in the world especially in sub-Saharan Africa has led to an unprecedented global effort to ensure access to antiretroviral ( ARV ) drugs . Given that medication-taking behavior can immensely affect an individual 's response ; ART adherence is now widely recognized as an ' Achilles heel ' for the successful outcome . The present study was undertaken to investigate the rate and predictors of adherence to antiretroviral therapy among HIV-infected persons in southwest Ethiopia . Methods The study was conducted in the antiretroviral therapy unit of Jimma University Specialized Hospital . A prospect i ve study was undertaken on a total of 400 HIV infected person . Data were collected using a pre-tested interviewer-administered structured question naire at first month ( M0 ) and third month ( M3 ) follow up visits . Results A total of 400 and 383 patients at baseline ( M0 ) and at follow up visit ( M3 ) respectively were interviewed . Self-reported dose adherence in the study area was 94.3 % . The rate considering the combined indicator ( dose , time and food ) was 75.7 % . Within a three month follow up period , dose adherence decreased by 2 % and overall adherence rate decreased by more than 3 % . Adherence was common in those patients who have a social support ( OR , 1.82 , 95%CI , 1.04 , 3.21 ) . Patients who were not depressed were two times more likely to be adherent than those who were depressed ( OR , 2.13 , 95%CI , 1.18 , 3.81 ) . However , at the follow up visit , social support ( OR , 2.42 , 95%CI , 1.29 , 4.55 ) and the use of memory aids ( OR , 3.29 , 95%CI , 1.44 , 7.51 ) were found to be independent predictors of adherence . The principal reasons reported for skipping doses in this study were simply forgetting , feeling sick or ill , being busy and running out of medication in more than 75 % of the cases . Conclusion The self reported adherence rate was high in the study area . The study showed that adherence is a dynamic process which changes overtime and can not reliably be predicted by a few patient characteristics that are assumed to vary with time . Adherence is a process , not a single event , and adherence support should be integrated into regular clinical follow up Purpose The primary goal of this analysis was to examine the influence of depression above and beyond the effects of HIV treatment on work activity and function . Methods We combined data from three longitudinal studies of patients starting antiretroviral therapy ( ART ) and /or entering HIV care in Ug and a. Assessment s were conducted at baseline and months 6 and 12 . The nine-item Patient Health Question naire ( PHQ-9 ) was used to assess depressive symptoms , as well as Major ( scores > 9 ) and Minor ( scores 5–9 ) Depression status ; work functioning was assessed using a subscale of the Medical Outcomes Study HIV Health Survey ( MOS-HIV ) . Multivariate r and om-effects logistic regression models for longitudinal data were used to examine the impact of treatment on work status and optimal work functioning , with measures of both baseline and change in physical health functioning , cognitive functioning and depression in the models , controlling for baseline demographics , and CD4 cell count . Results The sample of 1,731 participants 
    Output:
    
Low socio-economic conditions in PLHIV on ART , female sex and immunosuppression in mixed/untreated PLHIV were frequently reported as associated factors but with no consensus .