Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

Abstract

Introduction Concern over mental health morbidity affecting people living with HIV is increasing worldwide. The objective of this study was to describe the longitudinal trajectories of depression and anxiety, and mental health service utilization among people newly diagnosed with HIV. Methods This was an observational cohort study that enrolled people newly diagnosed with HIV consecutively and followed them for one year in Changsha, China. Socio‐demographic, clinical and psychological data were collected at the baseline and at one‐year follow‐up. Participants were recruited between March 1, 2013 and September 30, 2014. The final follow‐up was in September 30, 2015. Results Among 557 people newly diagnosed with HIV enrolled at the baseline, 410 (73.6%) completed the one‐year follow‐up survey (median (interquartile range) age at follow‐up: 29 (25, 39) years; 376 men (91.7%)), and were included in the analysis. 39.3% and 30.2% of the 410 participants were screened with significant symptoms of depression and anxiety at baseline respectively. An overall drop in the prevalence of each condition was found at follow‐up, however, 10.5% and 6.1% of participants were found to have persistent depression and anxiety. The results of mixed‐effect models showed that bisexuality, homosexual transmission, other clinical symptoms (for example, not on antiretroviral therapy (ART)), non‐disclosure, higher levels of HIV/AIDS‐related stress, and lack of social support were associated with significant symptoms of depression and anxiety. One year after diagnosis, 8.3% had visited healthcare providers for emotional or psychological problems. Conclusions Despite the obvious need people newly diagnosed with HIV in China rarely seek professional help. Integrating depression and anxiety screening and referral into HIV care settings is warranted.

Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV

“…The mortality rate from suicide is 1%, with suicide mortality rates declining post ART initiation [ 54 ]. Anxiety disorders, particularly generalized anxiety disorder (GAD), are also commonly comorbid conditions in PLWH, with 25–33% experiencing clinically significant anxiety [ 47 , 57 , 63 ]. Internalized stigma has a significant indirect effect on anxiety through self-blame [ 49 ].…”

Comparison of Psycho-Social Factors Associated With Suicidal Ideation and Suicide Attempts Among People Living With HIV in Central West China

“…Sixth, HIV-positive course of illness varied across different participants, and those with longer illness courses may have a higher probability of experiencing SI or SA. Although there is some conflicting evidence, as previous studies reported that PLWH with longer courses coped with stress better than those with shorter courses (40).…”

The Disparities in Mental Health Between Gay and Bisexual Men Following Positive HIV Diagnosis in China: A One-Year Follow-Up Study

“…A systematic review has shown that the median prevalence of depression and anxiety among HIV-positive individuals are 60.64% and 43.13% in China, respectively [40]. Unfortunately, poor sustainability and fragmented care of mental health care remains largely an unresolved issue in China [24]. According to the Gelberg-Andersen Behavioral Model for vulnerable populations, the HIV-related stigma might be an important factor associated with the mental health care utilization [41].…”

“…The data reported in this study derives from a longitudinal study focusing on the mental health among newly diagnosed people living with HIV. A detailed description of study design is available elsewhere [24]. Briefly, participants were consecutively recruited from the Changsha Center for Disease Control and Prevention (CDC) from March 1, 2013, to August 30, 2014.…”