Association Between Stigma, Depression and Quality of Life of People Living with HIV/AIDS (PLHA) in South India - a Community Based Cross Sectional Study

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2012 Jun 23

PMID 22720691

Citations 92

Authors

Bimal Charles

Lakshmanan Jeyaseelan

Arvind Kumar Pandian

Asirvatham Edwin Sam

Mani Thenmozhi

Visalakshi Jayaseelan

Affiliations

Soon will be listed here.

Abstract

Background: India has around 2.27 million adults living with HIV/AIDS who face several challenges in the medical management of their disease. Stigma, discrimination and psychosocial issues are prevalent. The objective of the study was to determine the prevalence of severe stigma and to study the association between this, depression and the quality of life (QOL) of people living with HIV/AIDS (PLHA) in Tamil Nadu.

Methods: This was a community based cross sectional study carried out in seven districts of Tamil Nadu, India, among 400 PLHA in the year 2009. The following scales were used for stigma, depression and quality of life, Berger scale, Major Depression Inventory (MDI) scale and the WHO BREF scale. Both Stigma and QOL were classified as none, moderate or severe/poor based on the tertile cut off values of the scale scores. Depression was classified as none, mild, moderate and severe. Logistic regression analyses were performed to study the risk factors.

Results: Twenty seven per cent of PLHA had experienced severe forms of stigma. These were severe forms of personalized stigma (28.8%), negative self-image (30.3%), perceived public attitude (18.2%) and disclosure concerns (26%). PLHA experiencing severe depression were 12% and those experiencing poor quality of life were 34%. Poor QOL reported in the physical, psychological, social and environmental domains was 42.5%, 40%, 51.2% and 34% respectively. PLHA who had severe personalized stigma and negative self-image had 3.4 (1.6-7.0) and 2.1 (1.0-4.1) times higher risk of severe depression respectively (p < .001). PLHA who had severe depression had experienced 2.7(1.1-7.7) times significantly poorer QOL.

Conclusions: Severe forms of stigma were equivalently prevalent among all the categories of PLHA. However, PLHA who had experienced severe depression had only developed poor QOL. A high level of social support was associated with a high level of QOL.

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References

Chandra P, Deepthivarma S, Manjula V . Disclosure of HIV infection in south India: patterns, reasons and reactions. AIDS Care. 2003; 15(2):207-15. DOI: 10.1080/0954012031000068353. View

Steward W, Bharat S, Ramakrishna J, Heylen E, Ekstrand M . Stigma is associated with delays in seeking care among HIV-infected people in India. J Int Assoc Provid AIDS Care. 2012; 12(2):103-9. PMC: 3482419. DOI: 10.1177/1545109711432315. View

Stevelink S, van Brakel W, Augustine V . Stigma and social participation in Southern India: differences and commonalities among persons affected by leprosy and persons living with HIV/AIDS. Psychol Health Med. 2011; 16(6):695-707. DOI: 10.1080/13548506.2011.555945. View

Gupta R, Dandu M, Packel L, Rutherford G, Leiter K, Phaladze N . Depression and HIV in Botswana: a population-based study on gender-specific socioeconomic and behavioral correlates. PLoS One. 2010; 5(12):e14252. PMC: 2999532. DOI: 10.1371/journal.pone.0014252. View

Herek G . Thinking about AIDS and stigma: a psychologist's perspective. J Law Med Ethics. 2003; 30(4):594-607. DOI: 10.1111/j.1748-720x.2002.tb00428.x. View

Chandra P, Desai G, Ranjan S . HIV & psychiatric disorders. Indian J Med Res. 2005; 121(4):451-67. View

Fleischer N, Fernald L, Hubbard A . Depressive symptoms in low-income women in rural Mexico. Epidemiology. 2007; 18(6):678-85. DOI: 10.1097/EDE.0b013e3181567fc5. View

Jayarajan N, Chandra P . HIV and mental health: An overview of research from India. Indian J Psychiatry. 2011; 52(Suppl 1):S269-73. PMC: 3146205. DOI: 10.4103/0019-5545.69245. View

Nebhinani N, Mattoo S, Wanchu A . Psychiatric morbidity in HIV-positive subjects: a study from India. J Psychosom Res. 2011; 70(5):449-54. DOI: 10.1016/j.jpsychores.2010.09.021. View

10.

Maman S, Abler L, Parker L, Lane T, Chirowodza A, Ntogwisangu J . A comparison of HIV stigma and discrimination in five international sites: the influence of care and treatment resources in high prevalence settings. Soc Sci Med. 2009; 68(12):2271-8. PMC: 2696587. DOI: 10.1016/j.socscimed.2009.04.002. View

11.

Berger B, Ferrans C, Lashley F . Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001; 24(6):518-29. DOI: 10.1002/nur.10011. View

12.

Gendelman H, Lipton S, Tardieu M, Bukrinsky M, Nottet H . The neuropathogenesis of HIV-1 infection. J Leukoc Biol. 1994; 56(3):389-98. DOI: 10.1002/jlb.56.3.389. View

13.

Kohli R, Sane S, Kumar K, Paranjape R, Mehendale S . Assessment of quality of life among HIV-infected persons in Pune, India. Qual Life Res. 2005; 14(6):1641-7. DOI: 10.1007/s11136-004-7082-8. View

14.

Steward W, Herek G, Ramakrishna J, Bharat S, Chandy S, Wrubel J . HIV-related stigma: adapting a theoretical framework for use in India. Soc Sci Med. 2008; 67(8):1225-35. PMC: 2603621. DOI: 10.1016/j.socscimed.2008.05.032. View

15.

Basavaraj K, Navya M, Rashmi R . Quality of life in HIV/AIDS. Indian J Sex Transm Dis AIDS. 2011; 31(2):75-80. PMC: 3122586. DOI: 10.4103/0253-7184.74971. View

16.

Shan D, Ge Z, Ming S, Wang L, Sante M, He W . Quality of life and related factors among HIV-positive spouses from serodiscordant couples under antiretroviral therapy in Henan Province, China. PLoS One. 2011; 6(6):e21839. PMC: 3128110. DOI: 10.1371/journal.pone.0021839. View

17.

Chandra P, Krishna V, Ravi V, Desai A, Puttaram S . Hiv related admissions in a psychiatric hospital a five year profile. Indian J Psychiatry. 2011; 41(4):320-4. PMC: 2963836. View

18.

Wingood G, DiClemente R, Mikhail I, McCree D, Davies S, Hardin J . HIV discrimination and the health of women living with HIV. Women Health. 2007; 46(2-3):99-112. DOI: 10.1300/J013v46n02_07. View

19.

Kumarasamy N, Safren S, Raminani S, Pickard R, James R, Krishnan A . Barriers and facilitators to antiretroviral medication adherence among patients with HIV in Chennai, India: a qualitative study. AIDS Patient Care STDS. 2005; 19(8):526-37. DOI: 10.1089/apc.2005.19.526. View

20.

Thomas B, Rehman F, Suryanarayanan D, Josephine K, Dilip M, Dorairaj V . How stigmatizing is stigma in the life of people living with HIV: a study on HIV positive individuals from Chennai, South India. AIDS Care. 2005; 17(7):795-801. DOI: 10.1080/09540120500099936. View