Prevalence of depression, anxiety, and stress among human immunodeficiency virus patients in Swabi District, Pakistan

Abstract

Background: HIV infection causes psychological distress, with depression, anxiety, and stress as frequent comorbidities. However, data on their prevalence in rural Pakistan is limited. This study aimed to determine their prevalence and associated factors in Swabi District, Pakistan. Methods: A cross-sectional study was conducted in the Infectious Diseases Department of MTI Bacha Khan Medical Complex, Swabi, Pakistan. A total of 323 patients who were on antiretroviral treatment and suffered from HIV were selected based on convenience sampling method. The Depression, Anxiety, and Stress Scale-21 (DASS-21) was applied for identifying the psychological distress of patients. SPSS version 21 was used for statistical analysis of data through descriptive statistics, chi-square, independent t-test and ANOVA. Results: 56.7% of patients suffered from depression (n=183); the same percentage of them had anxiety (n=183); 52.3% were characterized by stress (n=169). Significantly high levels of mean DASS scores in females and transgender respondents were found in comparison to male patients in terms of all three scales (p<0.001). In bivariate analysis, it was determined that gender, marital status, education, occupation, place of residence, socioeconomic status, CD4 count, clinical stage, opportunistic infections, social support, stigma, and disclosure were significantly correlated with depression, anxiety, and stress (p<0.001). Conclusion: Over half of the participants with HIV from this study have depression, anxiety or stress. The screening and intervention for mental health problems should be incorporated into the HIV service package. Keywords: Anxiety, Depression, HIV, Pakistan, Stress.