Sustained Viral Suppression and its association with Psychiatric Morbidity and Sleep Quality among Older Adults with Human Immunodeficiency Virus: Evidence from a Retrospective Cohort in Ibadan, Nigeria
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Purpose
Older adults with HIV are at risk of psychiatric disorders and poor sleep quality, but evidence from sub-Saharan Africa is limited, particularly regarding sustained viral suppression. This study examined the prevalence of psychiatric disorders and poor sleep quality symptoms and their association with sustained viral suppression among older adults with HIV in Nigeria.
Methods
A retrospective cohort study was conducted among older adults receiving care at a tertiary HIV clinic in Ibadan, Nigeria. Viral load data from 2019-2023 were abstracted from medical records to determine sustained viral load suppression, while psychiatric morbidity and sleep quality were assessed cross-sectionally in 2023. Psychiatric morbidity, including major depressive disorder, anxiety disorder, bipolar disorder and mania, was assessed using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Mixed-effects logistic regression assessed changes in viral suppression over time and associations with psychiatric morbidity and sleep quality.
Results
Among 400 participants, 63.5% were female and mean age was 58.2 years (± 6.5). The 12-month prevalence of major depressive disorder was 25.8% while 17.5% had anxiety disorder, 29.3% had poor sleep quality, 3.3%, bipolar disorder, and 1.0% mania. Viral suppression improved significantly over the retrospective period. Sustained viral suppression was significantly associated with higher odds of good sleep quality (OR = 1.69, 95% CI: 1.07–2.66, p = 0.025), but not psychiatric morbidity.
Conclusion
Psychiatric disorders and poor sleep quality are common among older adults with HIV in Nigeria. Sustained viral suppression was associated with better sleep quality but not psychiatric morbidity highlighting the importance of integrating mental health and sleep assessment into comprehensive HIV care for older adults.
