The outcomes of anxiety and depression symptom screening in a population with HIV: Insights from an HIV service in Northern Italy.

OBJECTIVE

Screening for mental health symptoms is crucial in people with chronic conditions, including individuals with HIV, and recommended indeed by Guidelines. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) are validated tools used and endorsed by guidelines to screen for anxiety and depression symptoms. This study aimed to evaluate the prevalence and risk factors for anxiety and depression symptoms and quality of life (QoL) assessment in a cohort living with HIV in an HIV service in Northern Italy.

METHODS

We performed a cross-sectional analysis in adult people with HIV who completed the screening with the GAD-7 and PHQ-9 questionnaires, along with a QoL assessment using the Visual Analogue Scale (VAS). People with known mental health disorders, dementia, cognitive impairment, or who were unable to complete the questionnaires were excluded. Moderate-to-severe anxiety and depression symptoms were defined according to standard cut-offs of the GAD-7 (≥10) and PHQ-9 (≥10), respectively. A QoL score ≥ 60 was considered indicative of good well-being. Descriptive statistics and logistic regression analyses were conducted to investigate the associations between mental health symptoms and demographics, clinical and behavioural factors.

RESULTS

One thousand four hundred and forty-nine people with HIV, were included. Moderate-to-severe anxiety was identified in 14.4% (9.7% moderate, 4.7% severe), and moderate-to-severe depression in 11.9% (8.7% moderate, 3.2% severe). Suicidal ideation over the last 2 weeks was reported in 5.1% of participants, who were referred for immediate psychiatric counselling. In multivariate models, female gender was significantly associated with moderate-to-severe anxiety (aOR: 1.59, 95% CI: 1.09-2.31, p = 0.014), whereas Black African ethnicity was a protective factor (aOR: 0.39, 95% CI: 0.17-0.82, p = 0.020). Female gender also emerged as a significant risk factor for moderate-to-severe depression (aOR: 1.74, 95% CI: 1.16-2.59; p = 0.006). 1235 (85.2%) participants self-reported having a good quality of life.

CONCLUSION

Our findings underscore that people with HIV face a substantial burden of anxiety and depression symptoms. Women with HIV appear to be particularly vulnerable to both conditions, whereas Black African ethnicity appears to confer resilience against anxiety. These results highlight the requirement to integrate routine mental health screening into HIV care and tailor-specific interventions to gender and cultural contexts.