Gender disparities in depression severity and coping among people living with HIV/AIDS in Kolkata, India

Abstract

People living with HIV/AIDS (PLH) experience high rates of depression and related psychosocial risk factors that vary by gender. This study examines gender differences in depression severity among antiretroviral therapy (ART) patients (n = 362) from a large government ART clinic in Kolkata, India. Hypotheses for multiple linear regression models were guided by an integrated gendered stress process model focusing on variables reflecting social status (age, partner status), stressors (stigma), and resources (income, social support). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS); 22% of the sample reached the cutoff for severe depression, 56% moderate, and 13% mild depression. Compared to men, women reported lower income, education (50% no formal education vs. 20% men), availability of emotional and instrumental support, and were less likely to be married or cohabiting (53% women vs. 72% of men). However, more women had partners who were HIV-positive (78% women vs. 46% men). Overall, depression severity was negatively associated with availability of emotional support and self-distraction coping, and positively associated with internalized HIV/AIDS stigma, availability of instrumental support, and behavioral disengagement coping. Interactions for instrumental support by income and partner status by age varied significantly by gender. Analyses stratified by gender indicated that: 1) Frequently seeking instrumental support from others was protective for men at all income levels, but only for high-income women; and 2) having a partner was protective for men as they aged, but not for women. These results suggest that gender disparities in depression severity are created and maintained by women’s lower social status and limited access to resources. The effect of stigma on depression severity did not vary by gender. These findings may inform the tailoring of future interventions to address mental health needs of PLH in India, particularly gender disparities in access to material and social resources for coping with HIV.Trial Registration: ClinicalTrials.gov registration #NCT02118454, registered April 2014.

Factors Associated with Depression and Anxiety in Adults ≥60 Years Old during the COVID-19 Pandemic: A Systematic Review

“…Among the socio-demographic factors, the female gender is the most frequently associated with depression and anxiety [21,23,[27][28][29][30][31]. These findings are consistent with other reviews focused on the general population and healthcare workers during the pandemic [6,7] and more studies before COVID-19 [19,34,35]. Previous research suggests that this gender disparity may be mediated by variables that concern work, economic, educational, neuro-hormonal, psychological and genetic aspects [34,[36][37][38].…”

A trend analysis of people living with human immunodeficiency virus attending an anti-retroviral therapy centre in urban Bangalore

“…Unlike many studies where the percentage of females were found to be higher than the males, [9][10][11][12][13] in the present study it is observed that male cases were higher compared to females by 10% and could be due to better awareness and diminished fear of stigma.…”

Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study

“…As found in SARSrelated stigma studies, media miscommunications of risk mitigation strategies and inconsistent health policy have augmented uncertainty toward sudden viral epi and pandemics (Lee et al, 2005) resulting in widespread fear and anxiety. Previous scientific studies have shown that the internalized HIV stigma was a strong predictor of depression (Swendeman et al, 2018). The influence of COVID-19 stigma on the mental status of patients is worth discussing in future studies.…”