Prevalence and Risks of Depression and Substance Use Among Adults Living with HIV in the Asia–Pacific Region

on behalf of the Substance use, Stigma, Depression and Disability (S2D2) study group of IeDEA Asia-Pacific

Research output: Contribution to journalArticlepeer-review


Despite the mental health and substance use burden among people living with HIV (PLHIV) in the Asia–Pacific, data on their associations with HIV clinical outcomes are limited. This cross-sectional study of PLHIV at five sites assessed depression and substance use using PHQ-9 and ASSIST. Among 864 participants, 88% were male, median age was 39 years, 97% were on ART, 67% had an HIV viral load available and < 1000 copies/mL, 19% had moderate-to-severe depressive symptoms, and 80% had ever used at least one substance. Younger age, lower income, and suboptimal ART adherence were associated with moderate-to-severe depressive symptoms. Moderate-to-high risk substance use, found in 62% of users, was associated with younger age, being male, previous stressors, and suboptimal adherence. Our findings highlight the need for improved access to mental health and substance use services in HIV clinical settings.

Original languageEnglish
Pages (from-to)3862-3877
Number of pages16
JournalAIDS and Behavior
Issue number12
Publication statusPublished - 2022 Dec

Bibliographical note

Funding Information:
Funding support was provided through a grant to amfAR, The Foundation for AIDS Research from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing. The content of this research is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions above.

Funding Information:
The authors are grateful to the study participants and all site staff for their commitment to the study. The S2D2 Study Group: MP Lee, I Chan, YT Chan, SM Au, Queen Elizabeth Hospital, Hong Kong SAR; JY Choi, Na S, JH Kim, JM Kim, Yonsei University College of Medicine, Seoul, South Korea; I Azwa, R Rajasuriar, ML Chong, JY Ong, University Malaya Medical Centre, Kuala Lumpur, Malaysia; R Ditangco, MI Melgar, ES Gomez, Research Institute for Tropical Medicine, Muntinlupa City, Philippines; A Avihingsanon, C Padungpol, J Jamthong, S Thammasala, S Phonphithak, P Chaiyahong, HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; AH Sohn, JL Ross, B Petersen, C Chansilpa, TREAT Asia, amfAR, Bangkok, Thailand; MG Law, A Jiamsakul, The Kirby Institute, UNSW Sydney, Australia.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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