HIV-related stigma and psychological distress in a cohort of patients receiving antiretroviral therapy in Nigeria

Figures & data

Table 1. Descriptive characteristics of study population.

Study Population and Descriptive Characteristics, N = 288
Age (years)
Mean	40.04 (± 9.21)
Median	38
Gender
Female	179 (62%)
Male	110 (38%)
Marital Status
Married	146 (51%)
Unmarried	142 (49%)
Education
None/Primary	50 (17%)
Secondary/Tertiary	238 (83%)
Employment
Formal Employment	136 (47%)
No Formal Employment	137 (49%)
Unknown	15
Disclosure
Early	239 (83%)
Late/Never	49 (17%)
Poverty Assessment
< 1.25 USD/day	30 (10%)
≥ 1.25USD/day	258(90%)
Food Insecurity
Secure	263 (91%)
Insecure	25 (9%)
CD4 Count
<200	112 (39%)
≥200	166 (58%)
Unknown	10 (3%)

Table 2. Perception of stigma and stigma subtypes in the study population.

Perceived Stigma
Stigma Type	Cohort Mean	Cohort Range	Scale Range
Overall	102.34	80–126	40–160
Personalized	40.55	36–58	18–72
Disclosure	29.47	20–36	10–40
Negative Self-Image	32.42	26–39	13–52
Public	51.88	40–62	20–82

Table 3. HIV-related stigma by patient characteristics.

	Overall Stigma		Personalized Stigma		Disclosure Stigma		Negative Self Image Stigma		Public Stigma
Sex
Female	102.23	0.69	40.31	0.14	29.49	0.84	32.48	0.50	51.77	0.38
Male	102.51		40.94		29.44		32.31		52.06
Age Category
18–29 years	102.73	0.66	40.63	0.89	29.16	0.23	33.00	0.13	51.87	0.97
≥30 years	102.29		40.53		29.51		32.35		51.88
Marital Status
Unmarried	103.25	<0.01*	40.90	0.06	29.62	0.20	3286	<0.01*	52.12	0.11
Married	101.39		40.18		29.31		32.95		51.63
Education
None/Primary	101.30	0.10	40.08	0.16	29.18	0.21	32.24	0.46	51.56	0.26
Secondary/Tertiary	102.56		40.65		29.53		32.45		51.95
Disclosure
Early	100.80	<0.01*	39.47	<0.01*	29.15	<0.01*	32.02	<0.01*	51.25	<0.01*
Late/Never	109.84		45.78		31.04		34.35		55.96
Formal Employment
Yes	102.21	0.80	40.42	0.56	29.44	0.71	32.39	0.99	51.70	0.28
No	102.39		40.65		29.53		32.39		52.04
Poverty Assessment
Below $1.25	101.40	0.15	39.97	0.21	29.47	0.98	31.93	0.05	51.60	0.42
≥ $1.25	102.45		40.61		29.47		32.47		51.92
Food Security
Secure	102.27	0.55	40.53	0.71	29.41	0.14	32.41	0.87	51.88	0.94
Insecure	103.04		40.80		30.12		32.48		51.92
CD4 Count
<200	101.33	0.02*	40.07	0.04*	29.06	<0.01*	32.14	0.08	51.46	0.02*
≥200	102.91		40.83		29.72		32.57		52.16

Table 4. Association between HIV-related stigma and psychological distress⁺.

	Odds Ratio	95% CI
Overall Stigma	1.05	1.00–1.09
Personalized Stigma	1.08	1.00–1.16
Disclosure Stigma	1.05	0.93–1.18
Negative Self-Image	1.13	1.00–1.27
Public Stigma	1.06	0.97–1.16

⁺ Logistic regression. See Methods for details. CI: confidence interval

Table 5. Predictors of psychological distress 12 Months after ART Initiation Among PLWH in Nigeria.

	Unadjusted Analysis		Adjusted Model with Overall Stigma		Adjusted Model with Personalized Stigma		Adjusted Model with Negative Self Image Stigma
	cOR	95% CI	aOR	95% CI	aOR	95% CI	aOR	95% CI
Gender
Male	1		1		1		1
Female	2.57	1.52–4.34	2.33	1.26–4.23	2.34	1.27–4.33	2.32	1.26–4.27
Age	1.010	0.98–1.04	1.04	1.00–1.07	1.035	1.00–1.07	1.04	1.00–1.07
Marital Status
Unmarried	1		1		1		1
Married	0.14	0.19–0.53	0.32	0.18–0.58	0.32	0.18–0.58	0.32	0.18–0.58
Education
None/Primary	1		1		1		1
Secondary/Tertiary	1.10	0.58–2.07	0.91	0.41–1.99	0.91	0.42–1.99	0.912	0.42–2.00
Employment
No formal employment	1		1		1		1
Formal Employment	0.77	0.47–1.26	0.79	0.40–1.23	0.70	0.40–1.23	0.698	0.40–1.23
Disclosure
Early	1		1		1		1
Late/Never	2.60	1.39–4.86	2.41	0.99–5.87	2.29	0.82–6.38	2.44	1.10–5.40
CD4 Count
<200	1		1		1		1
≥200	1.37	0.83–2.26	1.27	0.71–2.28	1.27	0.71–2.27	1.27	0.71- 2.28
Poverty Assessment
<$1.25	1		1		1		1
≥$1.25	1.25	0.56–2.77	1.28	0.48–3.42	1.28	0.48–3.42	1.28	0.48–3.42
Food Insecurity
Secure	1		1		1		1
Insecure	0.61	0.25–1.52	0.38	0.13–1.15	0.39	0.13–1.15	0.38	0.13–1.15
Overall Stigma	1.05	1.00–1.09	1.00	0.94–1.07
Personalized Stigma	1.08	1.00–1.16			1.01	0.90–1.14
NSI Stigma	1.13	1.00–1.27					1.01	0.86–1.17

Adjusted models include overall, personalized, or negative self-image (NSI) stigma.