Perceived Family Support, Depression, and Suicidal Ideation among People Living with HIV/AIDS: A Cross-Sectional Study in the Kathmandu Valley, Nepal

Abstract

BackgroundDepression and suicidal thinking occur frequently alongside HIV/AIDS, triggering profound detrimental impacts on quality of life, treatment adherence, disease progression, and mortality. Yet the psychosocial factors contributing to these psychiatric comorbidities remain underexplored, particularly in the developing country context. This study thus examined different dimensions of perceived family support in relation to depression and suicidal ideation among people living with HIV/AIDS (PLWHA) in Nepal.MethodsA cross-sectional survey of 322 adult PLWHA residing in the Kathmandu Valley, Nepal was conducted. Data were analyzed using multiple logistic regressions for correlates of Beck Depression Inventory (BDI)-Ia-defined depressive symptoms and suicidal ideation in the past 2 weeks. Perceived family support, measured using the 10-item Nepali Family Support and Difficulty Scale, was entered into separate models, in turn, as a composite score, for each sub-scale (emotional, instrumental, and negative support), and for each individual item.ResultsOverall, 25.5% of participants registered BDI-Ia-defined depression, with significantly lower rates among those with perceived family support scores in the highest (AOR = 0.19; 95% CI = 0.07, 0.55) and middle (AOR = 0.38; 95% CI = 0.17, 0.86) tertiles relative to those with lowest-tertile scores. Meanwhile, 14.0% reported suicidal thinking, with significantly lower rates among those in the highest perceived family support tertile relative to the lowest (AOR = 0.25; 95% CI = 0.07, 0.91). Broken down by support sub-scale, only negative support (i.e. family difficulty) was significant in its correlations with both outcomes – a trend similarly reflected in the item-wise analyses.ConclusionsOur findings highlight an important role for family support in determining experiences of depression and suicidality among PLWHA. Incorporating family counseling and support services – with special focus on ameliorating negative interaction and bolstering emotional support – into HIV care and treatment services may help to improve mental health along with overall wellness and treatment outcomes for HIV-positive populations in Nepal and similar settings.

Depression in HIV Positives under ART in TUTH Clinic: A Cross-Sectional Study

“…MDD among HIV population was associated with family history of affective disorder, alcohol dependency disorder, and female gender. 9 Similar to previous studies 11,12 our study showed that majority (n=36, 36.4%) belonged to age group 30-39 yrs. In our study, the males (n=49, 49.5%) and the females (n=50, 50.5%) were almost equal in number, which can be counted for one of the strengths of the study.…”

“…A community based crosssectional study of 322 adult PLWHA in the Kathmandu valley, reported 25.5% to have BDIdefined depression. 9 An specialty HIV clinic at a tertiary care centre of South India reported syndromal depression in 40 percent of seropositive individuals. Severity of depressive symptoms was related to abuse or dependence on alcohol (47%), and poor social support (43%) 8 This study was an attempt to study depression in PLWHA under ART in an out-patient clinic in TUTH, a tertiary centre hospital of this country located in the capital city, Kathmandu.…”

Dificuldades do viver com HIV/Aids: Entraves na qualidade de vida

“…Family support is one of the most important forms of social support for people in situations of vulnerability, being an important protective factor for the development of psychosocial disorders such as depressive symptoms and suicidal thoughts. (7,12) When the family environment is insufficient, or unable to meet their demands, PLWHA sought support in society in general, represented here as a network of individuals and institutions that had no family relationship with the participants. The participants' statements, and the way the words be-haved in the classes, point to a situation of helplessness, in which individuals do not have social or emotional support.…”

“…Another characteristic of the study participants was being older (<50), which makes them more likely to have less social support and develop mental health problems. (12,14) The perception by PLWHA of health services as an obstacle to their quality of life is an alarming finding. The constant procedures, considered routine for professionals, become symbolic and representative images of the disease.…”

Dietary B Vitamins and Depression in Persons with Human Immunodeficiency Virus Infection: The Positive Living with HIV (POLH) Study

“…The study procedures have been reported in detail elsewhere (50)(51)(52)(53)(54)(55)(56). In brief, HIVinfected persons were recruited through the network of five non-government organizations (NGOs) working with HIV-infected persons in the Kathmandu Valley.…”