Effects of Depression Alleviation on Work Productivity and Income Among HIV Patients in Uganda

Published in: International Journal of Behavioral Medicine, [Epub February 2017]. 

Posted on RAND.org on March 16, 2017

by Glenn Wagner, Bonnie Ghosh-Dastidar, Eric Robinson, Victoria K. Ngo, Peter Glick, Seggane Musisi, Dickens Akena

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Research Question

  1. Does treatment improve work productivity among depressed people living with HIV?

Purpose

Depression is common among people living with HIV, and it is associated with impaired work functioning. However, little research has examined whether depression alleviation improves work-related outcomes in this population, which is the focus of this analysis.

Method

A sample of 1028 depressed HIV clients in Uganda enrolled in a comparative trial of depression care models and were surveyed over 12 months. Serial regression analyses examined whether depression alleviation (measured by the nine-item Patient Health Questionnaire) was associated with change in self-reported weekly amount of hours worked and income earned, and whether these relationships were mediated by change in work-related self-efficacy.

Results

Among those with major depression, depression alleviation was associated with nearly a doubling of weekly hours worked in bivariate analysis. The relationship between depression alleviation and hours worked was partially mediated by change in work self-efficacy among those with major depression, as well as those with minor depression, in multivariate regression analysis that controlled for demographic and health covariates. Depression alleviation was not significantly associated with change in weekly income.

Conclusion

These findings suggest that depression alleviation benefits work functioning at least in part through improved confidence to engage in work-related activities. Integration of depression care services into HIV care may be important for improving the economic well-being of people living with HIV.

Key Findings

  • When depression symptoms among participants were alleviated, the number of hours they worked nearly doubled.
  • Depression treatment was associated with increased self-efficacy, or confidence in one's ability to work and function well in a work environment.
  • The increased amount of time worked did not necessarily increase participants' income.

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