Gender-Specific Determinants of Depression Among People with HIV in Kazakhstan
G Mergenova, A Bukharbayeva, A Izekenova, A Terlikbayeva, S Primbetova, M Darisheva, M Yerdenova, J DeHovitzAbstract
Background
Depression is common among people living with HIV (PWH) and adversely affects treatment outcomes and quality of life. Determinants may differ by gender, yet evidence from Central Asia remains limited. This study assessed gender-specific factors associated with depression among PWH in Kazakhstan.
Methods
We conducted a cross-sectional study of 196 PWH (83 women, 113 men) randomly selected from the registry of Almaty AIDS center, Kazakhstan. Depression was assessed using the PHQ-9 (score >5). Poisson regression with robust variance was used to estimate adjusted prevalence ratios (aPRs) separately for women and men. Independent variables included HIV-related stigma, perceived stress (PSS-10), socioeconomic factors, health behaviors, antiretroviral therapy adherence, and comorbidities.
Results
Depression prevalence was 27.7% among women and 36.3% among men. In both groups, higher perceived stress was associated with depression (women: aPR=1.15; 95% CI: 1.07–1.23; men: aPR=1.09; 95% CI: 1.03–1.15). Among women, employment was associated with lower prevalence of depression (aPR=0.44; 95% CI: 0.21–0.90). Among men, hazardous alcohol use was associated with higher depression prevalence (aPR=1.92; 95% CI: 1.11–3.34), while chronic disease showed a borderline association (aPR=1.97; 95% CI: 1.00–3.90).
Conclusions
Depression is highly prevalent among people living with HIV in Kazakhstan and is more common in men than in women in our sample. Determinants differ by gender: in women, depression is primarily associated with psychosocial and socioeconomic factors, while in men, behavioral risk factors and comorbidities play a greater role, along with stress. These findings highlight the need for gender-specific mental health interventions within HIV treatment.
Key messages
• Depression is more common among men living with HIV in Almaty, Kazakhstan.
• Gender-specific approaches should inform the development of individualized mental health interventions.