Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi

Figures & data

Table 1. Descriptive characteristics of the sample.

Demographic Characteristic	Summary Statistic
Gender
Female (n)	81% (275)
Male (n)	19% (64)
Age
18–30 (n)	15% (52)
31–50 (n)	64% (216)
51-70+ (n)	21% (71)
Marital Status	1% (4)
Single (n)	20% (69)
Married (n)	46% (155)
Divorced (n)	24% (81)
Widowed (n)	10% (34)
Any Source of Income?
No (n)	36% (123)
Yes (n)	64% (216)
Any Education?
No (n)	11% (38)
Yes (n)	89% (301)
Depression Severity^a
Moderate (n)	75% (255)
Severe (n)	25% (84)
Internalized Stigma
ARSS^b Score; scale: 0–6 (SD)	3.4 (2.3)
ISMI^c Score; scale: 8–32 (SD)	24.3 (4.9)
Disability
WHODAS^d Score; scale: 0–45 (SD)	14.3 (7.7)
Social Support
MSPSS^e Score; scale: 12–84 (SD)	58.9 (17.4)

^a Depression severity is considered moderate if PHQ-9 score was between 10–14 and considered severe if PHQ-9 score was 15 or greater. ^b ARSS stands for AIDS-Related Stigma Scale. ^c ISMI stands for Internalized Stigma for Mental Illness Scale. ^d WHODAS stands for WHO Disability Assessment Schedule. ^e MSPSS stands for Multidimensional Scale of Perceived Social Support.

Figure 1. Prevalence of Internalized Stigma for HIV.

Figure 2. Prevalence of Internalized Stigma for Mental Illness.

Table 2. Correlates of internalized stigma.

	Internalized Stigma for HIV		Internalized Stigma for Mental Illness
Client Characteristic	Odds ratio (SE)	P-Value, 95%CI	Coefficient (SE)	P-Value, 95%CI
Age (Years)	0.98 (0.01)	0.03*, 0.96-1.00	0.00 (0.03)	0.99, −0.05, 0.05
Gender
Male	1.47 (0.41)	0.17, 0.84-2.55	−0.83 (0.74)	0.26, −2.29, 0.63
Female	Ref	Ref	Ref	Ref
Any Source of Income
Yes	0.85 (0.19)	0.46, 0.55-1.31	−2.23 (0.55)	<0.001***, −3.31, −1.15
No	Ref	Ref	Ref	Ref
Marital Status
Dating	0.98 (0.82)	0.98, 0.19-5.09	−0.30 (2.36)	0.90, −4.95, 4.34
Divorced	1.12 (0.28)	0.66, 0.68-1.86	−1.10 (0.66)	0.10, −2.41, 0.20
Single	1.07 (0.29)	0.82, 0.62-1.82	0.98 (0.70)	0.17, −0.41, 2.36
Widowed	0.80 (0.30)	0.54, 0.38-1.66	−0.99 (0.97)	0.31, −2.89, 0.92
Married	Ref	Ref	Ref	Ref
Any Education
Yes	0.51 (0.16)	0.04*, 0.27-0.95	0.28 (0.81)	0.73, −1.32, 1.89
No	Ref	Ref	Ref	Ref
Depression Level
Severe	0.95 (0.22)	0.82, 0.60-1.49	0.07 (0.60)	0.90, −1.11, 1.25
Moderate	Ref	Ref	Ref	Ref
WHODAS^a (range: 0-48)	1.02 (0.01)	0.11, 0.99-1.04	0.05 (0.03)	0.15, −0.02, 0.12
MSPSS^b (range: 12-84)	0.98 (0.01)	0.001***, 0.97-0.99	0.00 (0.02)	0.79, −0.03, 0.03
ARSS^c (range: 0-6)	.	.	0.48 (0.11)	<0.001***, 0.25, 0.70
ISMI^d (range: 8-32)	1.09 (0.02)	<0.001***, 1.05-1.14	.	.

Note: ***p ≤ 0.001; **p ≤ 0.01; *p ≤ 0.05. ^aWHODAS stands for WHO Disability Assessment Schedule. ^bMSPSS stands for Multidimensional Scale of Perceived Social Support. ^cARSS stands for AIDS-Related Stigma Scale. ^dISMI stands for Internalized Stigma for Mental Illness Scale.

Data availability statement

Deidentified data available upon request (email: [email protected]).