A cross-sectional study on the mental health among non-starting ART people living with HIV/AIDS under the ART expansion era

Objective To investigate the mental health status among PLWH (people living with HIV/AIDS) who had not started ART before in Guangzhou under the ART expansion era and to analyze the association between social support, social stigma and self-stigma with depression and anxiety in different time since confirmation of HIV infection, respectively. Methods A cross-sectional survey was conducted in 6 districts of Guangzhou. Data were collected on demographic characteristics, HIV-related health status, depression status, anxiety status, perceived social support, perceived social stigma and self-stigma of HIV positive participants. To investigate the influencing factors of depression and anxiety, respectively, Logistic regression analysis were applied to identify their associations. Results Of the 452 participants, the depression detection rate was 66.2%(299/452) and the anxiety detection rate was 52.9%(239/452). Multivariate logistic regression analysis revealed that, among PLWH with less than 1 month since confirmation of HIV infection, family support(OR=0.80, 95% CI:0.63-1.00, P=0.049) and self-stigma(OR=2.15, 95% CI:1.36-2.44, P=0.001) were significantly associated with depression, significant others support(OR=0.68, 95% CI:0.53-0.87, P=0.003) and self-stigma(OR=2.31, 95% CI:1.55-3.43, P<0.001) were significantly associated with anxiety; among PLWH with 1 month or more since confirmation of HIV infection, self-stigma(OR=2.72, 95% CI:1.74-4.25, P<0.001) was significantly associated with anxiety. Conclusions Depression and anxiety are common among people living with HIV/AIDS who had not started ART in Guangzhou. Self-stigma is an important influencing factor of anxiety and depression. Different source of supports have different effect toward depression and anxiety among PLWH in different time since confirmation of HIV infection, so the social support should be targeted to provide for PLWH.