Harder-to-reach people living with HIV experiencing high prevalence of all-type mental health disorder diagnosis

ABSTRACT

People living with HIV/AIDS (PHA) often concurrently cope with mental health disorders that may greatly influence HIV and other health-related outcomes. The objective of this study was to examine the prevalence and correlates of self-reported mental health disorder diagnosis among a cohort of harder-to-reach HIV-positive individuals in British Columbia, Canada. Between 2007 and 2010, 1000 PHA who had initiated ART were enrolled in the Longitudinal Investigation into Supportive and Ancillary health services (LISA) study. Socio-demographic, behavioral, health-care utilization and psychosocial information was collected through interviewer-led questionnaires and linked to longitudinal clinical variables through the provincial Drug Treatment Program at the BC Centre for Excellence in HIV/AIDS. We identified the prevalence of all-type and specific mental health disorders among this population. Of the 916 participants included in this analysis, 494 (54%) reported ever having a mental health disorder diagnosis. Mood (85%) and anxiety (65%) disorders were the two most frequently reported mental health conditions. Self-reported all-type mental health disorder was independently associated with decreased overall functioning (adjusted odds ratio [AOR] = 0.90, 95% confidence interval [CI] = 0.83–0.98) and life satisfaction (AOR = 0.81, 95% CI = 0.74–0.89), and having higher stigma score (AOR = 1.11, 95%CI = 1.02–1.21). Participants reporting any mental health disorder were more likely to report a history of sexual assault (AOR = 2.45, 95% CI = 1.75–3.43) and to have used case management services (AOR = 1.63, 95%CI = 1.17–2.27). Our findings uncovered a high burden of mental health disorders among harder-to-reach PHA and suggest that PHA with at least one mental health disorder diagnosis are disproportionately impacted by sexual violence and stigma.

KEYWORDS:

• Mental health
• psychiatric conditions
• HIV/AIDS
• depression
• quality of life

Acknowledgements

We thank Eirikka K. Brandson for her contribution to early versions of the manuscript and data collection, and Erin Ding and Kimberly A. Fernandes for their help with statistical analyses. We are also grateful for the contributions of the co-investigators of the LISA project: Dr Rolando Barrios, Dr David Burdge, Dr Marianne Harris, Dr David Henderson, Dr Thomas Kerr, Dr Julio S.G. Montaner, Dr Thomas Patterson, Dr Eric Roth, Dr Mark W. Tyndall, Dr Brian Willoughby and Dr Evan Wood. The LISA research team is thankful for the cooperation of our various research sites. We are inspired by their amazing dedication to their clients and the communities they serve. We would especially like to thank the participants of the LISA study who trust us with sensitive and intimate information and share their stories in hopes of supporting research projects that will make a difference in their communities. We humbly listen and interpret their experiences and hope that we are doing them justice.

Human participation protection

Written informed consent was obtained from participants according to a protocol approved by the University of British Columbia/Providence Health Care, Simon Fraser University, the University of Victoria, and Vancouver Coastal Health Research Ethics Board.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The LISA Project is supported by the Canadian Institutes for Health Research (CIHR) [grant number 53396] and the British Columbia Centre for Excellence in HIV/AIDS.