NIJAMSS peer-reviewed article

Determinants of Clinically Significant Depressive Symptoms among Adults Re-engaging in HIV Care after Antiretroviral Therapy Interruption at Moi Teaching and Referral Hospital, Kenya: A Mixed-Methods Cross-Sectional Study

Judith Kerubo Kambona; Margaret Disiye; Peter Onderi

Abstract: Background: Mental-health conditions are common among people living with HIV and can weaken adherence, retention and quality of life. Patients re-engaging after antiretroviral therapy (ART) interruption may carry a particularly high psychosocial burden, yet evidence from this population remains limited in Kenya. Objective: To determine the socio-demographic, psychosocial and clinical factors associated with clinically significant depressive symptoms among adults returning to HIV care after ART interruption at the AMPATH Comprehensive Care Clinic, Moi Teaching and Referral Hospital, Eldoret. Methods: An analytical cross-sectional mixed-methods study enrolled adults aged 18 years or older with documented ART interruption exceeding 28 days. Of a target sample of 299, 204 completed interviewer-administered questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), yielding a 68.2% response rate. Associations were examined using chi-square tests and multivariable binary logistic regression. Qualitative interviews and focus-group discussions were analyzed thematically and triangulated with quantitative findings. Results: Clinically significant depressive symptoms (PHQ-9 of 10 or higher) were identified in 81.4% of participants, while 47.1% had moderately severe or severe symptoms. Independent predictors included high perceived stress (adjusted odds ratio [AOR] 5.72, 95% confidence interval [CI] 2.31-14.15), age 36-50 years (AOR 4.87, 95% CI 1.67-14.19), marital disruption (AOR 3.94, 95% CI 1.52-10.24), frequent food insecurity (AOR 3.48, 95% CI 1.59-7.62), low social support (AOR 2.76, 95% CI 1.28-5.97), work or time conflict (AOR 2.63, 95% CI 1.23-5.62) and fear of disclosure stigma (AOR 2.14, 95% CI 1.02-4.48). Qualitative findings highlighted isolation, stigma, food insecurity and cumulative stress. Conclusion: Depressive symptoms were highly prevalent among adults returning after ART interruption and were driven principally by psychosocial and structural factors. Integrated mental-health screening, stepped psychosocial care, food-security referral, stigma reduction and differentiated HIV-service delivery should be embedded in re-engagement pathways.

Keywords: Antiretroviral therapy; Depression; HIV; Kenya; Mental-health integration; PHQ-9; Psychosocial determinants; Treatment interruption

Journal

Nexus International Journal of Applied Science, Medicine and Social Sciences

e-ISSN

3144-2196

Publication date

August 2026

Volume / Issue

Vol. 1, Issue 2

Paper number

012

Article type

Original Research

Published paper ID

NIJAMSS-V1S2-AUG2026-012

Publisher

Nexus Academic Press

Access

Open Access

Full text PDF: https://www.nijamss.org/archives-download/nijamss-vol-1-series-2-august-2026-paper-012.pdf