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. 2023 Feb 6;20(1):6.
doi: 10.1186/s12981-022-00498-5.

Exploring HIV status as a mediator in the relationship of psychological distress with socio-demographic and health related factors in South Africa: findings from the 2012 nationally representative population-based household survey

Nolusindiso Ncitakalo  1 , Lovemore Nyasha Sigwadhi  2 , Musawenkosi Mabaso  3 , John Joska  4 , Leickness Simbayi  4   5   6
Affiliations

Exploring HIV status as a mediator in the relationship of psychological distress with socio-demographic and health related factors in South Africa: findings from the 2012 nationally representative population-based household survey

Nolusindiso Ncitakalo et al. AIDS Res Ther. .

Abstract

Background: Psychological distress as measured by mental disorders like depression and anxiety is more prevalent in people living with HIV (PLHIV) than in the general population. However, the relationship between mental disorders and HIV is complex and bidirectional. Improved understanding of the relationship between mental disorders and HIV is important for designing interventions for this group. This paper explores the interrelationships of psychological distress with HIV and associated socio-demographic and health-related factors.

Methods: This secondary data analysis used the 2012 South African population-based household survey on HIV collected using a cross-sectional multi-stage stratified cluster sampling design. Generalized structural equation modelling (G-SEM) path analysis was used to explore the direct and indirect relationships of socio-demographic, health and HIV-related factors with psychological distress as measured by Kessler 10 scale using HIV status as a moderator variable.

Results: A total of 20,083 participants were included in the study, 21.7% reported psychological distress, of whom (32.6%) were HIV positive. In the final path model with HIV status as a moderator, psychological distress was significantly more likely among age group 25-49 years (AOR: 1.4 [95% CI 1.3-1.6]), age 50 years and older, (AOR: 1.4 [95% CI 1.2-1.6]), females (AOR: 1.6 [95% CI 1.4-1.8]), high risk drinkers (AOR: 1.9 [1.6-2.2]) hazardous drinkers (AOR: 4.4 [95% CI 3.1-6.3]), ever tested for HIV (AOR: 1.2 [95% CI 1.1-1.3]). Psychological distress was significantly less likely among the married [AOR: 0.8 (0.7-0.9)], other race groups [AOR: 0.5 (0.5-0.6)], those with secondary level education (AOR: 0.9 [95% CI 0.8-0.9]), and tertiary level education (AOR: 0.7 [95% CI 0.6-0.9]), those from rural informal [AOR: 0.8 (0.7-0.9)], and rural formal [AOR: 0.8 (0.7-0.9)] areas and those who rated their health as excellent/good [AOR: 0.4 (0.4-0.5)].

Conclusion: The findings highlight the importance of designing tailored interventions targeted at psychological distress among PLHIV especially the elderly, females, those with no education and / or low education attainment and those residing in informal urban areas.

Keywords: HIV status; Psychological distress; South Africa; Structural Equation Model.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual model of the relationship between psychological distress, mediator variable HIV status, socio-demographic, health and HIV-related variables
Fig. 2
Fig. 2
Final path model of the relationship between psychological distress, mediator variable, socio-demographic, health and HIV related variables
See this image and copyright information in PMC

References

    1. Dwyer-Lindgren L, Cork MA, Sligar A, Steuben KM, Wilson KF, Provost NR, Mayala BK, VanderHeide JD, Collison ML, Hall JB. Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017. Nature. 2019;570:189–193. - PMC - PubMed
    1. Belayneh Z, Mekuriaw B, Mehare T, Shumye S, Tsehay M. Magnitude and predictors of common mental disorder among people with HIV/AIDS in Ethiopia: a systematic review and meta-analysis. BMC Public Health. 2020;20:689. - PMC - PubMed
    1. Lofgren SM, Bond DJ, Nakasujja N, Boulware DR. Burden of depression in outpatient HIV-infected adults in Sub-Saharan Africa; Systematic review and meta-analysis. AIDS Behav. 2020;24:1752–1764. - PMC - PubMed
    1. Kulisewa K, Stockton MA, Hosseinipour MC, Gaynes BN, Mphonda S, Udedi MM, et al. The role of depression screening and treatment in achieving the UNAIDS 90–90-90 goals in Sub-Saharan Africa. AIDS Behav. 2019;23(2):153–161. - PMC - PubMed
    1. World Health Organization and Calouste Gulbenkian Foundation . Social determinants of mental health. Geneva: World Health Organization; 2014.

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