Internalized stigma and mental health disorders among people living with HIV in Akwa Ibom State, Nigeria

Assessing internalized stigma and mental health disorders among people living with HIV (PLWH) could identify subgroups that might benefit from targeted interventions. This cross-sectional study sought to evaluate internalized HIV stigma (IHS) and mental health disorders among 405 PLWH attending HIV clinics in Akwa Ibom State, Nigeria.

While waiting to see the doctor for their appointment, participants completed a 2-item instrument from the Functional Assessment of HIV Infection (FAHI), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder questionnaire (GAD-7). These questionnaires were used to assess IHS, depression symptoms, and anxiety symptoms, respectively. Data were collected between October and November 2023 and analyzed with SPSS v.25.0.

A clear majority of the participants (77.8%) reported that it was hard to tell others about their HIV infection. Overall, 129 (31.9%) participants reported high IHS. While most of the participants (69.9%) did not report any depression symptoms, 67 (16.5%) reported severe depression symptoms. Similarly, 72.1% did not report any anxiety symptoms, while 17.3% reported severe anxiety symptoms. Age (p = 0.009), duration on antiretroviral therapy (p < 0.001), and membership in a support group (p = 0.048) significantly predicted self-reported depression symptoms, while age (p = 0.003) and duration on antiretroviral therapy (p < 0.001) were significant predictors of self-reported anxiety symptoms. IHS score had a positive correlation with symptoms of depression (r_s = 0.63, p < 0.001) and anxiety (r_s = 0.64, p < 0.001).

While IHS was common among participants, mental health disorders were less frequently reported. Nevertheless, targeted psychosocial and pharmacological interventions may enhance the mental well-being of PLWH.