Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec 1;18(Suppl 5):20289.
doi: 10.7448/IAS.18.6.20289. eCollection 2015.

How does living with HIV impact on women's mental health? Voices from a global survey

Luisa Orza  1   2 , Susan Bewley  3 , Carmen H Logie  4 , Elizabeth Tyler Crone  5 , Svetlana Moroz  6 , Sophie Strachan  7 , Marijo Vazquez  1   2 , Alice Welbourn  8
Affiliations

How does living with HIV impact on women's mental health? Voices from a global survey

Luisa Orza et al. J Int AIDS Soc. .

Abstract

Introduction: Women living with HIV experience a disproportionate burden of mental health issues. To date, global guidelines contain insufficient guidance on mental health support, particularly regarding perinatal care. The aim of this article is to describe the extent and impact of mental health issues as experienced by women living with HIV on their sexual and reproductive health and human rights (SRH&HR).

Methods: A global, mixed-methods, user-led and designed survey on SRH&HR of women living with HIV was conducted using snowball sampling, containing an optional section exploring mental health issues. Statistical quantitative data analysis included descriptive statistics, correlation and multiple linear regression analysis for the mental health responses. Thematic analysis of open free-text responses was performed for qualitative data.

Results: A total of 832 respondents from 94 countries participated in the online survey with 489 responses to the optional mental health section. Of the respondents, 82% reported depression symptoms and 78% rejection. One-fifth reported mental health issues before HIV diagnosis. Respondents reported experiencing a 3.5-fold higher number of mental health issues after diagnosis (8.71 vs 2.48, t[488]=23.00, p<0.001). Nearly half (n=224; 45.8%) had multiple socially disadvantaged identities (SDIs). The number of SDIs was positively correlated with experiencing mental health issues (p<0.05). Women described how mental health issues affected their ability to enjoy their right to sexual and reproductive health and to access services. These included depression, rejection and social exclusion, sleep problems, intersectional stigma, challenges with sexual and intimate relationships, substance use and sexual risk, reproductive health barriers and human rights (HR) violations. Respondents recommended that policymakers and clinicians provide psychological support and counselling, funding for peer support and interventions to challenge gender-based violence and to promote HR.

Conclusions: Interventions addressing intersecting stigmas and any especial impacts of diagnosis during pregnancy are required to ensure women's SRH&HR. Global policy guidelines regarding women living with HIV must incorporate mental health considerations.

Keywords: HIV; evidence base; gender-based violence; human rights; intimate partner violence; mental health; survey; values and preferences; women.

PubMed Disclaimer

References

    1. Murray C, Naghavi M, Wang H, Lozano R. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71. - PMC - PubMed
    1. Responding to intimate partner violence and sexual violence against women. WHO clinical and policy guidelines [Internet] WHO; 2013. [cited 2015 Nov 7]. Available from: http://www.who.int/reproductivehealth/publications/violence/978924154859... - PubMed
    1. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference; 19–22 June; New York. 1946. signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
    1. Kamen C, Arganbright J, Kienitz E, Weller M, Khaylis A, Shenkman T, et al. HIV-related stigma: implications for symptoms of anxiety and depression among Malawian women. Afr J AIDS Res. 2015;14(1):67–73. - PMC - PubMed
    1. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips M, et al. No health without mental health. Lancet. 2007;370(9590):859–77. - PubMed

Publication types