{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:40:40Z","timestamp":1782459640596,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01 MH114721"],"award-info":[{"award-number":["K01 MH114721"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P2C HD050924"],"award-info":[{"award-number":["P2C HD050924"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["P30 AI050410"],"award-info":[{"award-number":["P30 AI050410"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01AI096299"],"award-info":[{"award-number":["U01AI096299"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Rapid antiretroviral treatment (ART) initiation reduces time from HIV infection to viral suppression, decreasing HIV transmission risk. Mental health symptoms may influence timing of ART initiation. This study estimated the prevalence of ART initiation at enrolment into HIV care and the relationship between mental health and ART initiation at enrolment into HIV care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted interviews with 426 individuals initiating HIV care in Cameroon between June 2019 and March 2020 to estimate the association between mental health and timing of ART initiation. Depression (Patient Health Questionnaire\u20109; cut\u2010point 10), anxiety (Generalized Anxiety Disorder\u20107; cut\u2010point 10), post\u2010traumatic stress disorder (PTSD) (PTSD Checklist for DSM\u20105; cut\u2010point 31) and harmful alcohol use (Alcohol Use Disorders Identification Test; cut\u2010point 16) were dichotomized to represent those with and without each exposure at first HIV care appointment. Date of ART initiation (date ART prescribed) was ascertained from medical records. Separate multivariable log\u2010binomial regression models were used to estimate the association between mental health exposures and ART initiation at enrolment into care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Overall, 87% initiated ART at enrolment into HIV care. Approximately 20% reported depressive symptoms, 15% reported PTSD symptoms, 12% reported anxiety symptoms and 13% reported harmful alcohol use. In multivariable analyses, individuals with moderate to severe depressive symptoms had 1.7 (95% confidence interval [CI] 1.1, 2.7) times the prevalence of not initiating ART at enrolment into HIV care compared to those with no or mild depressive symptoms. Those with symptoms of PTSD, compared to those without, had 1.9 (95% CI 1.2, 2.9) times the prevalence of not initiating ART at enrolment into HIV care. Symptoms of anxiety or harmful drinking were not associated with ART initiation at enrolment into HIV care in multivariable models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Symptoms of depression and PTSD were associated with lower prevalence of ART initiation at enrolment into HIV care among this sample of individuals initiating HIV care in Cameroon under a \u201ctreat all\u201d policy. Research should examine barriers to timely ART initiation, whether incorporating mental health services into HIV care improves timely ART initiation, and whether untreated symptoms of depression and PTSD drive suboptimal HIV care outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25842","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T07:44:26Z","timestamp":1637653466000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Mental health and initiation of antiretroviral treatment at enrolment into HIV care in Cameroon under a national \u201ctreat all\u201d policy: a cross\u2010sectional analysis"],"prefix":"10.1002","volume":"24","author":[{"given":"Angela M.","family":"Parcesepe","sequence":"first","affiliation":[{"name":"Department of Maternal and Child Health Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"University of North Carolina at Chapel Hill Carolina Population Center  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0355-4477","authenticated-orcid":false,"given":"Lindsey M.","family":"Filiatreau","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health Department of Epidemiology University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Vanes","family":"Ebasone","sequence":"additional","affiliation":[{"name":"Clinical Research Education Networking and Consultancy  Yaounde Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastase","family":"Dzudie","sequence":"additional","affiliation":[{"name":"Clinical Research Education Networking and Consultancy  Yaounde Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"Pence","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health Department of Epidemiology University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton","family":"Wainberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry New York State Psychiatric Institute and Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Yotebieng","sequence":"additional","affiliation":[{"name":"Department of Medicine Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Anastos","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Epidemiology &amp; Population Health Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Pefura\u2010Yone","sequence":"additional","affiliation":[{"name":"Jamot Hospital  Yaounde Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-5063","authenticated-orcid":false,"given":"Rogers","family":"Ajeh","sequence":"additional","affiliation":[{"name":"Clinical Research Education Networking and Consultancy  Yaounde Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Nash","sequence":"additional","affiliation":[{"name":"City University of New York Institute of Implementation Science in Population Health Graduate School of Public Health and Health Policy  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,22]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Guidelines for managing advanced HIV disesase and rapid initiation of antiretroviral therapy","author":"World Health Organization","year":"2017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600693"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001134"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002822"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030228"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-020-00473-4"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","unstructured":"UNAIDS. 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