Prevalence of stigma in people living with HIV, its effect on treatment adherence and psychiatric comorbid disease.

Abstract

HIV has become a rising healthcare issue in Pakistan in recent years with new outbreaks and spillover to traditionally low-risk groups. We studied the stigma around HIV, its relation to psychiatric comorbidities such as depression and anxiety, and adherence to treatment in people living with HIV (PLHIV). A hospital-based cross-sectional study was conducted over six months at a tertiary care hospital in Karachi, Pakistan. Self-administered digital questionnaires containing basic demographics, PHQ9, GAD7, HSS12, and GMAS scales were used to assess depression, anxiety, stigma, and medical adherence respectively. A total of 66 participants were included, with a mean age of 39.97 ± 14.32 years. The mean stigma score was 25.67 ± 9.46, with 9 participants (13.85%) experiencing severe stigma. Among the different stigma components, disclosure concerns had the highest mean score (7.91 ± 2.91). Most participants had no depression and a no-to-low risk for anxiety. No relationship was found between medical adherence and either stigma scores or psychiatric comorbidities. Patients identified as from key populations (n = 35) had significantly increased risk of depression (p = 0.0493), anxiety (p = 0.023), and HIV-associated stigma (p = 0.0166). Stigma continues to affect mental well-being and hinders early diagnosis and treatment of PLHIV. A comprehensive approach, cannot be complete without addressing this stigma and its effect on disease burden, diagnosis, and treatment.