The Factor Structure and Presentation of Depression Among HIV-Positive Adults in Uganda

Christina Psaros, Jessica E. Haberer, Yap Boum, Alexander C. Tsai, Jeffrey N. Martin, Peter W. Hunt, David R. Bangsberg, Steven Safren

Research output: Contribution to journalArticle

15 Scopus citations


Depression is one of the most prevalent psychiatric comorbidities of HIV and one of the greatest barriers to HIV self-care and adherence. Despite this, little consensus exists on how to best measure depression among people living with HIV/AIDS (PLWHA) in African settings. Measurement of depression among PLWHA may be confounded by somatic symptoms. Some research recommends excluding these items to enhance measurement validity; sensitivity may be lost with this approach. We sought to characterize depression among a cohort (N = 453) of PLWHA initiating antiretroviral therapy in Uganda via factor analysis of a widely used measure of depression, the Hopkins Symptom Checklist (HSCLD). Common factor analysis was performed, associations between HSCLD and the Mental Health subscale of the Medical Outcomes Study HIV (MOS-HIV) estimated, and a Cronbach’s alpha calculated to examine validity. Factor analysis yielded two factors: (1) somatic-cognitive symptoms and (2) behavioral disengagement. Persons with more versus less advanced disease (CD4 cell count of ≤200 cells/mm3) showed no statistically significant differences in depression scores (1.7 vs. 1.7, P ≥ 0.5). Both factors were significantly associated with the MOS-HIV (P 

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalAIDS and Behavior
Issue number1
StatePublished - 2014
Externally publishedYes



  • Assessment
  • Depression
  • Validity

ASJC Scopus subject areas

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

Cite this

Psaros, C., Haberer, J. E., Boum, Y., Tsai, A. C., Martin, J. N., Hunt, P. W., Bangsberg, D. R., & Safren, S. (2014). The Factor Structure and Presentation of Depression Among HIV-Positive Adults in Uganda. AIDS and Behavior, 19(1), 27-33.