Prevalence and associations of depression, anxiety, and stress among people living with HIV: A hospital-based analytical cross-sectional study

Sampson Opoku Agyemang; Jerry Ninonni; Lydia Bennin; Elizabeth Agyare; Leveana Gyimah; Kafui Senya; Emmanuel Birikorang; Emmanuel Nii-Boye Quarshie; Nyonuku Akosua Baddoo; Stephen Ayisi Addo; Dorcas Obiri-Yeboah

doi:10.1002/hsr2.754

Prevalence and associations of depression, anxiety, and stress among people living with HIV: A hospital-based analytical cross-sectional study

Health Sci Rep. 2022 Aug 8;5(5):e754. doi: 10.1002/hsr2.754. eCollection 2022 Sep.

Affiliations

¹ Department of Mental Health, School of Nursing and Midwifery University of Cape Coast Cape Coast Ghana.
² Public Health Unit, Cape Coast Teaching Hospital Cape Coast Ghana.
³ Communicable and Non-Communicable Diseases Cluster World Health Organisation Country Office Accra Ghana.
⁴ Department of Laboratory Technology, School of Physical Sciences University of Cape Coast Cape Coast Ghana.
⁵ Department of Psychology, School of Social Sciences University of Ghana Accra Ghana.
⁶ National AIDS/STIs Control Programme Accra Ghana.
⁷ Department of Microbiology and Immunology, School of Medical Sciences University of Cape Coast Cape Coast Ghana.

Abstract

Background and aims: An important but much less researched burden of human immunodeficiency virus (HIV) in Sub-Saharan Africa includes the associated mental health outcomes of living with the virus. This study aimed to estimate the prevalence of depression, anxiety, and stress, and describe some of the socio-demographic associations among people living with HIV (PLHIV) in Ghana.

Methods: A cross-sectional study was conducted at the Cape Coast Teaching Hospital, Ghana. Simple random sampling was used to recruit 395 PLHIV who access HIV-related services at the antiretroviral therapy clinic. The Depression, Anxiety, and Stress Scale-21 was used to assess prevalence of depression, anxiety, and stress. Frequencies and percentages were used to estimate the prevalence and multivariable logistic regression was used to evaluate sociodemographic factors associated with depression, anxiety, and stress.

Results: The prevalence estimates of depression, anxiety, and stress among PLHIV were 28.6% (95% confidence interval [CI] 24.4-33.3), 40.8% (95% CI = 36.0-45.8), and 10.6% (95% CI = 7.9-14.1), respectively. Females reported higher prevalence of depression (32.2%; 95% CI = 27.2-37.7), anxiety (44.0%; 95% CI = 38.4-49.6), and stress (12.6%; 95% CI = 9.4-17.0) compared to depression (17.5%; 95% CI = 11.1-26.4), anxiety (30.9%; 95% CI = 22.5-40.7), and stress (4.1%; 95% CI = 1.2-10.4) among males. PLHIV without a regular partner were about 0.63 increased odds of experiencing anxiety compared to those with a regular partner (AOR = 0.63, 95% CI = 0.40-1.00: p = 0.049). PLHIV without formal education were about 0.49 and 0.44 increased odds to experience anxiety and stress, respectively compared to those with tertiary education.

Conclusions: Generally, the levels of stress, anxiety, and depression are high among PLHIV, but disproportionately higher among females. Mental health assessment and management should be integrated into the HIV care services. There should be capacity building for health care workers to offer differentiated service delivery based on mental health care needs of PLHIV.

Keywords: Ghana; anxiety; depression; mental health; people living with HIV; stress.

Grants and funding

001/WHO_/World Health Organization/International