Stigma in Ethiopia: association with depressive symptoms in people with HIV

Abstract

Rates of depression among people living with HIV can be as high as 50%. In many settings, HIV-related stigma has been associated with depressive symptoms which may lead to poor engagement in care and ultimately, poorer health outcomes. Stigma is a major issue in Ethiopia but data examining the relationship between stigma and depression in Ethiopia are lacking. We performed a mixed-methods cross-sectional study to examine the relationship between stigma of HIV/AIDS and depressive symptoms in Gondar, Ethiopia. We interviewed patients who presented for routine HIV care at Gondar University Hospital during the study period, examining depressive symptoms and HIV/AIDS-related stigma using standardized measures. Multiple-regression was used to assess the relationship between depressive symptoms, stigma, and gender. Of 55 patients included in this analysis, 63.6% were female and most participants had limited formal education (69%, less than 12th grade education). The majority reported experiencing both stigma (78%) and depressive symptoms (60%) ranging in severity from mild to moderately severe. Higher levels of HIV-related stigma were significantly associated with higher levels of depressive symptoms (β = 0.464, p ≤ 0.001). Although gender was associated with stigma, it was not associated with depressive symptoms (β = −0.027, p > 0.05). Results suggest the importance of psychosocial issues in the lives of people with HIV in Ethiopia.

Keywords:

• depressive symptoms
• HIV
• stigma
• Ethiopia
• mixed methods

Acknowledgements

The authors would like to thank all of the participants of this study. We also like to thank the University of Gondar anti-retroviral therapy (ART) clinic staff who helped with recruitment. This study was funded by a fellowship award from Strengthening Care Opportunities through Partnership in Ethiopia (SCOPE). SCOPE is a partnership between University of Washington, University of Gondar, University Presbyterian Church, and the Ethiopian Orthodox Church.