Educational objectives There is paucity of data on mental health risk factors among women living with HIV in rural settings in low income countries. This study explores comorbid mental health risk factors among this vulnerable group. Purpose: To assess the prevalence and predictors of major depressive disorder (MDD) among women living with HIV in rural settings in India.
Methods A cross-sectional sample of 905 HIV-infected rural women aged between 18 and 49 years was recruited from District Anti Retroviral Therapy centre. Trained psychiatric social workers interviewed participants for perceived stigma, stress, social support, quality of life and also screened for depression. Those who had a score of 6 or above on Self Rating Questionnaire (SRQ) were further evaluated by for Major Depressive Disorder (MDD) using Mini International Neuropsychiatric Interview (MINI.5.0.0) by mental health professionals experienced in administering psychiatric rating scales.
Results The sample consisted of participants with mean age of 36.69 ± 7. 06 years, with largely uneducated (17.9%) or studied less than 7th grade (65.7%) and unskilled labourers (81.9%). About half of the respondents had lost their spouses due to HIV infection (45.5%). Majority of the respondents disclosed their HIV status only to their closest relatives (82.2%). In addition, they perceived it is risk to disclose their status to others (86.5%).
The prevalence of MDD was 19.6%. The MDD group had significantly higher scores for perceived stigma (p = 0.008), stress (p = 0.08) and a lower score for social support (p < 0.0001) compared to the non-depressed group. Further, on regression analysis, higher scores for stigma (p = 0.004), stress (p < 0.0001) and lower scores for social support (p = 0.004) predicted MDD.
Conclusions MDD is associated with various modifiable psycho-social risk factors among women with HIV. The study highlights that there is a need for developing a context appropriate psycho-social intervention to target depression among women living with HIV.
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