Mental Health Issues and Viral Suppression Among People Living with HIV/AIDS on Anti-Retroviral Therapy (ART) in Southeast Nigeria.

Background The intersection of mental health issues and HIV/AIDS poses a critical challenge in the comprehensive care and management of individuals living with HIV. People Living with HIV (PLHIV) on ART struggle with not only the physical aspects of the condition but also the psychological implications associated with it. HIV remain a significant health challenge in South-eastern Nigeria, with sub-optimal viral-suppression among PLHIV on ART. Understanding the intricate relationship between mental health problems and viral-suppression among PLHIV on ART becomes imperative. Therefore, this study explores the relationship between mental health issues and viral-suppression among this population in South-eastern, Nigeria. Methods An hospital-based unmatched Case-control study was conducted among 1,202 PLHIV, aged ≥10yrs and on ART. Cases were people living with HIV (PLHIV) on ART with suppressed viral load, while controls were those with non-suppressed viral load. Multi-stage random sampling techniques was utilized in selecting study participants. Patient-Health-Questionnaire (PHQ-2/PHQ-9), Perceived-Stress-Scale (PSS-10) and internalized AIDS-related stigma-scale (IA-RSS) were used to measure depression, perceived-stress and HIV-related stigma. Data were entered into SPSS Version-26 software and analyzed using descriptive statistics; (percentages, mean, standard deviation), and inferential statistics using logistic regression at <0.05 statistical significance. Result Majority were females (62.2%). (30.4%) and 10.9% were aged 25–34yrs and ≥55yrs respectively. Mean age was 17.7years (St. dev =12.2years). Depression (50.5%) was prevalent among participants, of which 25%, 22% and 53% were mildly, moderately and severely depressed. 44.1%, 23.4% and 32.5% had low, moderate and high perceived-stress, while 46.2% and 53.2% recorded high and low HIV-related stigma. Depression (p<0.001: Mild: AOR=0.37, 95% CI= 0.23-0.58; moderate: AOR=0.26, 95% CI= 0.15-0.44; severe: AOR=0.18, 95% CI= 0.11-0.29) and perceived-stress (p<0.001: AOR= 0.43, 95% CI= 0.28-0.67) were found to be significantly associated with viral suppression among PLHIV on ART. Conclusion: This study reveals a significant prevalence of depression and perceived stress among PLHIV on ART, indicating the urgent need for integrated mental health interventions within HIV care programs. Addressing mental health challenges through targeted support and interventions is essential to enhance the overall well-being of PLHIV and improve viral suppression outcomes in this population.