Depression and anxiety among people living with HIV on antiretroviral therapy: prevalence and correlates at the National Sexually Transmitted Diseases/AIDS programme, in Sri Lanka.

OBJECTIVE

Depression and anxiety are common among people living with HIV (PLHIV), leading to poor quality of life and reduced adherence to antiretroviral therapy (ART). Evidence from Sri Lanka is limited. This study aimed to assess the prevalence and correlates of depression and anxiety among Sinhala speaking PLHIV receiving ART at the National STD/AIDS Control Programme, Colombo.

RESULTS

A cross sectional study of 320 PLHIV used the validated Sinhala Hospital Anxiety and Depression Scale (HADS-S) and diagnostic interviews. Anxiety prevalence was 27.5% and depression 33.4%. Univariate analyses showed significant associations with female gender (anxiety p = 0.009; depression p < 0.001), low income (anxiety p = 0.005; depression p < 0.001), semi-urban residence (anxiety p = 0.003; depression p = 0.001), sexual minority/transgender identity (anxiety p < 0.001), sexual dysfunction (anxiety p = 0.001; depression p < 0.001), poor ART adherence (anxiety p < 0.001), marital status (anxiety p = 0.016; depression p < 0.001), non-disclosure (anxiety p = 0.008; depression p < 0.001), and suicidality (both p < 0.001). In multivariate regression, poor ART adherence predicted anxiety (OR = 16.45, 95% CI 6.48-41.75). Predictors of depression were HIV awareness > 1 year (OR = 10.10, 95% CI 1.16-87.76), female gender (OR = 3.32, 95% CI 1.42-7.77), marital status (married vs other, OR = 4.95, 95% CI 1.89-12.98), and income ≤ Rs.50,000 (OR = 2.74, 95% CI 1.35-5.56). Anxiety and depression correlated moderately (r = 0.319, p < 0.001). Only 8.1% received antidepressants despite 21.3% reporting suicidality.