Stigma in Ethiopia: association with depressive symptoms in people with HIV

Abstract

Rates of depression among people living with HIV can be as high as 50%. In many settings, HIV-related stigma has been associated with depressive symptoms which may lead to poor engagement in care and ultimately, poorer health outcomes. Stigma is a major issue in Ethiopia but data examining the relationship between stigma and depression in Ethiopia are lacking. We performed a mixed-methods cross-sectional study to examine the relationship between stigma of HIV/AIDS and depressive symptoms in Gondar, Ethiopia. We interviewed patients who presented for routine HIV care at Gondar University Hospital during the study period, examining depressive symptoms and HIV/AIDS-related stigma using standardized measures. Multiple-regression was used to assess the relationship between depressive symptoms, stigma, and gender. Of 55 patients included in this analysis, 63.6% were female and most participants had limited formal education (69%, less than 12th grade education). The majority reported experiencing both stigma (78%) and depressive symptoms (60%) ranging in severity from mild to moderately severe. Higher levels of HIV-related stigma were significantly associated with higher levels of depressive symptoms (β = 0.464, p ≤ 0.001). Although gender was associated with stigma, it was not associated with depressive symptoms (β = -0.027, p > 0.05). Results suggest the importance of psychosocial issues in the lives of people with HIV in Ethiopia.

Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi

“…A Ugandan study found 39% of their 447 HIV positive participants from ages 18–49 years screened positive for probable depression (Kaida et al, 2012). Higher levels of HIV-related stigma were significantly associated with elevated depressive symptoms (Endeshaw, Walson, Rawlins, Dessie, Alemu, Andrews, & Rao, 2014). Thus intervening at the PMTCT level itself might reduce psychiatric morbidity and improve adherence and engagement in the program (Abrams, Myer, Rosenfield, & El-Sadr, 2007).…”

Social Support, Stigma and Antenatal Depression Among HIV-Infected Pregnant Women in South Africa

“…In addition, recent evidence suggests that psychosocial factors and depression are interrelated. Studies conducted in sub-Saharan Africa have identified associations between depressive symptoms and both low levels of social support [15] and high levels of HIV-related stigma [16, 17], and recent research conducted among HIV-infected men and women in South Africa has reported that both HIV-related stigma and social support are independently associated with depression [18]. However, the interrelationships among these constructs are poorly understood, and most previous research has not explored the potentially moderating effect of these factors on the relationships between other factors and depression.…”

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

“…Stigma has consistently been associated with a number of mental health difficulties in cross-sectional and prospective analyses, including increased levels of anxiety, depression, and hopelessness, as well as decreases in self-esteem [12][13][14][15][16][17][18]. In addition, PLWH may face social consequences, such as negative social interactions [19] or loss of social support [17].…”