PREVALENCE AND FACTORS ASSOCIATED WITH DEPRESSIVE SYMPTOMS AMONG PEOPLE LIVING WITH HIV/AIDS ATTENDING AN ADULT ANTIRETROVIRAL THERAPY CLINIC AT FEDERAL MEDICAL CENTRE, BIDA

Abstract

Background: Depressive symptoms are common among people living with HIV/AIDS (PLWHA) and may adversely affect psychosocial wellbeing and HIV treatment outcomes. Several sociodemographic, psychosocial and clinical factors may be associated with depressive symptoms among PLWHA. This study determined the prevalence of depressive symptoms and examined factors associated with screen-positive depressive symptoms among PLWHA attending the adult Antiretroviral Therapy (ART) Clinic at Federal Medical Centre (FMC), Bida.

Methods: A hospital-based cross-sectional study was conducted from September to November 2021 among adults living with HIV/AIDS attending the ART Clinic of FMC Bida. Participants were selected using systematic sampling. Data were collected using a structured questionnaire, the Patient Health Questionnaire-9 (PHQ-9), Oslo-3 Social Support Scale and AK9 HIV Stigma Scale. The PHQ-9 was used to screen for depressive symptoms, with a score of ≥5 classified as screen-positive. Descriptive statistics and bivariate analyses were performed, followed by multivariable binary logistic regression. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at p<0.05.

Results: A total of 334 participants were studied. Overall, 202 (60.5%) screened positive for depressive symptoms, while 132 (39.5%) screened negative. The severity distribution was 132 (39.5%) with no/minimal depressive symptoms, 60 (18.0%) with mild symptoms, 51 (15.3%) with moderate symptoms, 47 (14.1%) with moderately severe symptoms and 44 (13.2%) with severe symptoms. In the bivariate analysis, sex, marital status, occupation, educational status, perceived HIV-related stigma, social support, CD4 count at diagnosis and viral load were significantly associated with screen-positive depressive symptoms. In the multivariable model, poor social support (AOR 22.923, 95% CI 7.278–72.195, p<0.001), moderate social support (AOR 27.100, 95% CI 9.459–77.638, p<0.001), no perceived HIV-related stigma compared with perceived stigma (AOR 0.121, 95% CI 0.031–0.473, p=0.002), divorced marital status compared with widowed status (AOR 0.032, 95% CI 0.003–0.371, p=0.006), and artisan occupation compared with unemployment (AOR 0.050, 95% CI 0.007–0.343, p=0.002) showed statistically significant adjusted associations. The estimates for divorced marital status and artisan occupation were imprecise, as reflected by their wide confidence intervals.

Conclusion: Screen-positive depressive symptoms were common among PLWHA attending the ART clinic at FMC Bida. Psychosocial factors, particularly social support and HIV-related stigma, showed strong adjusted associations with depressive symptoms. Integration of mental-health screening and psychosocial support into routine HIV care should be strengthened. Given the cross-sectional design, the observed associations should not be interpreted as causal.