Depression and Its Relationship to Work Status and Income among HIV Clients in Uganda

Purpose: Despite high levels of depression among persons living with HIV (PLWHIV), little research has investigated the relationship of depression to work status and income in PLWHIV in sub-Saharan Africa, which was the focus of this analysis. Methods: Baseline data from a prospective longitudinal cohort of 798 HIV patients starting antiretroviral therapy in Kampala, Uganda were examined. In separate multivariate analyses, we examined whether depressive severity and symptom type [as measured by the Patient Health Questionnaire (PHQ-9)] and major depression [diagnosed with the Mini International Neuropsychiatric Interview (MINI)] were associated with work status and income, controlling for demographics, physical health functioning, work self-efficacy, social support and internalized HIV stigma. Results: 14% of the sample had Major Depression and 66% were currently working. Each measure of depression (PHQ-9 total score, somatic and cognitive subscales; Major Depression diagnosis) was associated with not working and lower average weekly income in bivariate analysis. However, none of the depression measures remained associated with work and income in multivariate analyses that controlled for other variables associated with these economic outcomes. Conclusions: These findings suggest that while depression is related to work and income, its influence may only be indirect through its relationship to other factors such as work self-efficacy and physical health functioning.