Depression among people living with tuberculosis and tuberculosis/HIV coinfection in Ukraine: a cross-sectional study

Background: Depressive disorders are associated with poor treatment outcomes, physical health, and quality of life among people living with TB (PLWTB) and TB/HIV (PLWTBHIV). Data on depression among PLWTB/HIV are limited in Ukraine. Objectives: This cross-sectional study aimed to examine depression risk and its correlates and describe the willingness to seek depression treatment among PLWTB/HIV in Ukraine. Methods: This secondary analysis included patients with and without HIV who initiated TB treatment within 30 days in two tertiary hospitals in Kyiv and Odesa. A survey was conducted from February 2021 to October 2022 and reviewed patients’ health records. We used the Center for Epidemiological Studies-Depression Scale (CES-D) to indicate risk for clinical depression. Factors associated with depressive symptoms were identified using logistic regression. Results: The sample included 209 participants (n = 100 with TB; n = 109 with TB/HIV). The mean age of participants was 43 (SD = 11) years; 66% of sample identified as male. Approximately 28% of participants were at risk for clinical depression; of whom 66% were willing to seek therapeutic or medical help. HIV coinfection (adjusted odds ratio [aOR] = 2.95, 95% confidence interval [CI]: 1.46,6.20), past 30 days illicit drug use (aOR = 3.57, 95% CI = 1.18,11.60), TB stigma (moderate stigma aOR = 7.40, 95% CI = 2.22,34.1; high stigma aOR = 15.50, 95% CI = 4.52,73.20), and unemployment status (aOR = 2.25, 95% CI = 1.12,4.60) were significantly associated with the odds of depressive symptoms among PLWTB. Conclusion: Findings support integration of a brief depression screening tool into routine clinical care of PLWTB/HIV and highlight the importance of linking TB/HIV care with mental health services.