Prevalence and Determinants of Demoralization Syndrome among Middle-aged and Young Adults with HIV/AIDS: A Cross-sectional Study

Objective This study aims to examine the prevalence and influencing factors of despair syndrome in middle-aged and young individuals living with HIV/AIDS at a tertiary infectious disease hospital in China. The goal is to provide a foundation for the early identification of high-risk populations and to guide the development of targeted clinical interventions. Methods A convenience sampling approach was employed to recruit 280 middle-aged and young PLWHA who met the inclusion and exclusion criteria from a tertiary infectious disease hospital in Chengdu, China, between April and October 2024. Data were collected through a general demographic questionnaire, the Chinese version of the Despair Scale, the AIDS Discrimination Perception Scale, the Simple Disease Cognition Questionnaire, and the Chinese version of the Medical Coping Modes Questionnaire. Statistical analyses, including descriptive statistics, one-way ANOVA, Spearman's correlation, and multiple stepwise regression, were performed using SPSS 27.0. Results A total of 280 participants were included in the analysis, with 88.93% aged between 31 and 59 years, and 78.21% male. Univariate analysis revealed that educational attainment, monthly income per capita, CD4 + T lymphocyte count, HIV viral load, and the presence of opportunistic infections were significantly associated with the occurrence of despair syndrome among middle-aged and young HIV/AIDS patients (P < 0.05). Spearman’s correlation analysis demonstrated significant associations between despair syndrome and perceived discrimination, disease cognition, and two coping strategies—confrontation and yielding (P < 0.05). Multiple regression analysis identified monthly income (β = -0.112, P = 0.012), CD4 + T lymphocyte count (β = -0.145, P = 0.001), and HIV viral load (β = -0.103, P = 0.020) as significant negative predictors of despair syndrome, while educational level (β = 0.267, P < 0.001), opportunistic infections (β = 0.143, P = 0.001), discrimination perception (β = 0.123, P = 0.009), cognitive appraisal (β = 0.235, P < 0.001), and yielding coping style (β = 0.232, P < 0.001) were identified as significant positive predictors. These variables together explained 48.80% of the variance in despair syndrome. Conclusion Despair syndrome in middle-aged and young PLWHA is influenced by a variety of factors. Clinicians should place greater emphasis on the psychological well-being of these individuals, implementing tailored interventions that address the identified risk factors to prevent or delay the onset of frailty.