A systematic review: the role of spirituality in reducing depression in people living with HIV/AIDS.

Vermandere et al’s1 article highlighted endof-life care as a particular area where spirituality can play an important role. In a link between spirituality and another chronic disease we looked at spirituality and HIV (R Amuzie, unpublished data, 2009). Vermandere’s literature reviewproposes that spirituality has a key position in the management of HIV sufferers. HIV infection is a major global problem and in 2007 was present in 33million people around the world.2 Antiretroviral therapy has been successful in slowing the progression of HIV infection and reducing AIDS-related mortality. But by doing so, HIV infection is now widely considered as a chronic illness and therefore HIV sufferers are beleaguered by similar challenges as those living with chronic illnesses like epilepsy and diabetes mellitus.Researchsuggests thatpeoplewith HIV/AIDS are at greater risk of depression,3 and that depression in HIV sufferers is linked with more rapid loss of immune function, accelerated disease progression, and lower survival time.4 In clinical research, spirituality has been broadly defined as a belief in a higher power than oneself that is not thought to be God. Anotherdefinition is that spirituality is similar to an individuals’ experience of meaning and life purpose.5 It has been reported to reduce the risk of depression in people living with chronic illness. This reviewwas conducted to examine the possible benefits and impact of spirituality on depressive symptoms in people with HIV/AIDS. Systematic literature searchesofPubMed, PsycInfo, and Embase were carried out, along with backwards and forwards citation tracking of key studies, identified 21 qualitative studies, of which five studies6–10 met the predetermined criteria for eligibility and were included in the review. Formal meta-analysis was not possible due to the nature of the studies. This review found that a large number of people with HIV/AIDS report experiencing depressive symptoms that are suggestive of mild-moderate depression. Studies provide statistical evidence that a greater level of spirituality inapersonwithHIV/AIDS is linked to fewer symptoms of depression. However, further research is required to examine the association between spirituality and clinically-diagnosed depression, as well as the impact of spirituality-focused interventions in reducing depression in people with HIV infection or AIDS.