Stigma, Social Support, Illicit Drug Use, and Other Predictors of Anxiety and Depression Among HIV/AIDS Patients in Pakistan: A Cross-Sectional Study

Abstract

Introduction: Anxiety and depression in people living with HIV/AIDS (PLWHA) can lead to non-adherence to antiretroviral therapy (ART), morbidity, and mortality. Therefore, assessing the stigma, social support, and other determinants of anxiety and depression in PLWHA are important for developing further interventions.Methods: An institution-based cross-sectional study was conducted in 505 PLWHA, approached through systematic sampling, who paid routine visits to the ART center, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Data was collected by pretested validated hospital anxiety and depression scale (HADS). Version 26 of the SPSS was used to apply Logistic regression analysis to identify determinants, and the 95% confidence interval (CI) adjusted odds ratio (AOR) was calculated to assess the magnitude of the relationships.Results: In PLWHA, the prevalence of co-morbid depression and anxiety was 80%. Separately, 89.9% had depression, and 80.3% had anxiety. Use of illicit drugs [AOR = 1.87, 95% CI (1.01, 3.27)], low social support [AOR = 1.21, 95% CI (1.02, 2.25)], being male [AOR = 2.21, 95% CI (1.11, 5.49)], and HIV related stigma [AOR = 2.48, 95% CI (1.25, 6.02)] were significant predictors of depression. Having detectable viral load [AOR = 3.04, 95% CI (1.04, 8.86)], young age [AOR = 5.31, 95% CI (1.19, 29.39)], no formal education [AOR = 21.78, 95% CI (4.03, 117.62)], low [AOR = 1.70, 95% CI (1.12, 6.93)] or moderate [AOR = 2.20, 95% CI (1.79, 6.09)] social support, illicit drugs addiction [AOR = 1.17, 95% CI (1.03, 2.55)], and HIV stigma [AOR = 54.3, 95% CI (21.20, 139.32)] had a remarkable association with anxiety.Conclusions: Given the high prevalence of anxiety and depression among PLWHA, the Pakistan Ministry of Health should focus more on monitoring mental health, expanding mental health services, and developing interventions based on identified factors to treat depression and anxiety among PLWHA.

Exploring bridge symptoms in HIV-positive people with comorbid depressive and anxiety disorders

“…We found that “not feeling cheerful” and “not feeling relaxed” were the bridge symptoms in the depression and anxiety clusters, which indicated that these symptoms could serve as bridges between clusters. In complex networks, bridge nodes are essential for calculating the co-occurrence of clusters [ 26 ]. This result is noteworthy because a large number of PLWH may have both depressive and anxious symptoms at the same time due to stigma, intolerance of uncertainty, fear of death, and medications.…”

Brief Cognitive Behavior Therapy for Stigmatization, Depression, Quality of life, social support and Adherence to Treatment among Patients with HIV/AIDS: A Randomized Control Trial

“…However, after B-CBT treatment, participants perceived a signi cant positive change in social support [57,58]. When we educate the patients and train them through role plays, they try to look forward in social context, improve their social support system, and talk with others comfortably; they reduce their stigma and depression [59,60]. Increasing social support among patients improves the quality of life…”

Depression and Associated Factors Among Men Living with HIV/AIDS Aged 50 Years and Over in Chongqing, China

“…12 Current studies have also suggested that the prevalence of depression among HIV/AIDS patients could be higher in low-and middle-income countries compared with high-income countries, 13 ranging from 47% in the US 14 to 80% in Pakistan. 15 To be noted, initiative evidence from China has indicated that the prevalence of depressive symptoms is 74.2% among older adults with HIV/AIDS, 16 significantly higher than that among the general HIV/AIDS population (53.8%). 17 As one of the most common mental illnesses worldwide, depression has affected approximately 121 million people.…”