Yotebieng, MarcelZotova, NataliaBernard, CharlotteGoodrich, SuzanneRogers Awoh, AjehWatnick, DanaNsonde, Dominique MahambuTchiengang Moungang, Elodie FloreNguemo Noumedem, Julie LaureNko'o Mbongo'o, Guy CalvinMinga, AlbertSeydi, MoussaGandou, PaulKwobah, Edith KamaruAtwoli, LukoyeJaquet, AntoineWools-Kaloustian, KaraAnastos, KathrynIeDEA Consortium2024-10-172024-10-172024Yotebieng M, Zotova N, Bernard C, et al. Accuracy of nine-item Patient Health Questionnaire against psychiatric diagnosis for depression among people with HIV. AIDS. 2024;38(12):1765-1773. doi:10.1097/QAD.0000000000003963https://hdl.handle.net/1805/44021Objective: The aim of this study was to assess the performance of the nine-item Patient Health Questionnaire (PHQ-9) against psychiatrist diagnosis in people with HIV (PWH). Design: Cross-sectional analysis of data collected between January 2018 and July 2022 across five sites in Cameroon, Cote d'Ivoire, Kenya, Senegal, and the Republic of Congo. Participants were ≥18 years and receiving HIV care at the participating site. PHQ-9 was administered by study staff followed by a psychiatrist's evaluation within 3 days. Results: Overall, 778 participants with complete data were included: 297 (38.2%) in Cameroon, 132 (17.0%) in Congo, 148 (19.0%) in Cote d'Ivoire, 98 (12.6%) in Kenya, and 103 (13.2%) in Senegal. The area under the curve for PHQ-9 score was generally high ranging from 0.935 [95% confidence interval (CI): 0.893, 0.977] in Cote d'Ivoire to 0.768 (95% CI: 0.589, 0.947) in Congo. However, for the common cut-off score ≥10, sensitivity was low: 50% or lower in Cameroon, Congo and Senegal, 66.7% in Kenya and 70.6% in Cote d'Ivoire. But negative predictive values (NPV) were high: 98.9% (95% CI: 96.9%, 99.8%) in Cameroon, 96.1 (95% CI: 91.1, 98.7) in Cote d'Ivoire, 96.3% (95% CI: 89.7%, 99.2%) in Kenya, 95.7% (95% CI: 90.2%, 98.6%) in Congo, and 89.0% (95% CI: 81.2%, 94.4%) in Senegal. Interpretation: Across all countries, PHQ-9 score ≥10 performed very poorly (low sensitivity) as a tool to identify psychiatrist diagnosed depression. However, the observed high NPV suggests it can be used to rule out depression.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalDepressionHIVNine-item patient health questionnaireSensitivitySpecificitySub-Saharan AfricaArticle