Psychological Distress in a Population of People Living with HIV/AIDS in Nigeria: Association with Socio-demographics and Perceived Social Support

Adetunji Obadeji, Lateef Olutoyin Oluwole, Banji Ferdinand Kumolalo, Kehinde Oyeyemi Oderinde, Adedotun Samuel Ajiboye, Christopher Goson Piwuna


Background: Recent improvement in the care of People living with HIV/AIDS (PLHA) continues to change the face of HIV infection from a deadly disease to a chronic illness with attendance psychological sequelae. The objective of this present study was to examine the rate of psychological distress (PD), and its association with socio-demographics and perceived social support among PLHA.

Methods: This cross-sectional study was conducted among a population of PLHA in Ado-Ekiti, Nigeria. Participants completed a socio-demographic questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS), and the 10-item Kessler Psychological distress scale. Relationship between sociodemographic variables, social support and PD were examined using bivariate and multivariate analyses.

Results: Of 324 participants, 26.5% were experiencing PD. Being a female, unemployed, having no spouse, no post-test counseling or non-disclosure of status increases the odds of developing PD while the absence of complications significantly reduces the risk of developing psychological distress [OR=0.31 (95% CI: 0.17-0.56), AOR=0.20 (95% CI: 0.09-0.45)]. There was a significant negative correlation between PD and MSPSS (r= -0.116, p=0.037) and its Significant others subscale (r= -0.276, p=0.001).

Conclusions: The study findings emphasize the importance of enhancing social support systems for people living with HIV/AIDS in a bid to reduce psychological distress. Similarly, disclosure of illness and ensuring post-test counseling are essential in preparing PLHA to cope effectively after testing. Incorporating psychological assessment as well as care for PLHA will go a long way in improving treatment outcomes.


Clinical Psychology; Disclosure; Nigeria; People living with HIV/AIDS; Psychological distress; Social support; Depression and anxiety.

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Adams, C., Zacharia, S., Masters, L., Coffey, C., & Catalan, P. (2016). Mental health problems in people living with HIV: Changes in the last two decades: the London experience 1990–2014. AIDS Care, 28(sup1), 56–59.

Aloba, O., Opakunle, T., & Ogunrinu, O. (2019). Psychometric characteristics and measurement invariance across genders of the Multidimensional Scale of Perceived Social Support (MSPSS) among Nigerian adolescents. Health Psychology Report, 7(1), 69–80.

Anderson, T. M., Sunderland, M., Andrews, G., Titov, N., Dear, B. F., & Sachdev, P. S. (2013). The 10-item Kessler psychological distress scale (K10) as a screening instrument in older individuals. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 21(7), 596–606.

Antiretroviral Therapy Cohort Collaboration. (2008). Life expectancy of individuals on combination antiretroviral therapy in high-income countries: A collaborative analysis of 14 cohort studies. The Lancet, 372(9635), 293–299.

Asante, K. (2012). Social support and the psychological wellbeing of people living with HIV/AIDS in Ghana. African Journal of Psychiatry, 15(5), 340–345.

Ayana, T. M., Roba, K. T., & Mabalhin, M. O. (2019). Prevalence of psychological distress and associated factors among adult tuberculosis patients attending public health institutions in Dire Dawa and Harar cities, Eastern Ethiopia. BMC Public Health, 19(1), 1392.

Basha, E. A., Derseh, B. T., Haile, Y. G. E., & Tafere, G. (2019). Factors Affecting Psychological Distress among People Living with HIV/AIDS at Selected Hospitals of North Shewa Zone, Amhara Region, Ethiopia. AIDS Research and Treatment, 2019, 1–8.

Blashill, A. J., Gordon, J. R., & Safren, S. A. (2012). Appearance Concerns and Psychological Distress Among HIV-Infected Individuals with Injection Drug Use Histories: Prospective Analyses. AIDS Patient Care and STDs, 26(9), 557–561.

Brennan, D. J., Emlet, C. A., & Eady, A. (2011). HIV, Sexual Health, and Psychosocial Issues Among Older Adults Living with HIV in North America. Ageing International, 36(3), 313–333.

Camara, A., Sow, M. S., Touré, A., Sako, F. B., Camara, I., Soumaoro, K., Delamou, A., & Doukouré, M. (2020). Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018. Epidemiology and Infection, 148, e8–e8.

Canty-Mitchell, J., & Zimet, G. D. (2000). Psychometric Properties of the Multidimensional Scale of Perceived Social Support in Urban Adolescents. American Journal of Community Psychology, 28(3), 391–400.

Charles, Bimal, Jeyaseelan, L., Pandian, A. K., Sam, A. E., Thenmozhi, M., & Jayaseelan, V. (2012). Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India – a community based cross sectional study. BMC Public Health, 12(1), 463.

Chaudhury, S., Bakhla, A. K., & Saini, R. (2016, May 5). Prevalence, impact, and management of depression and anxiety in patients with HIV: A review. Neurobehavioral HIV Medicine; Dove Press.

Chippindale, S., & French, L. (2001). HIV counselling and the psychosocial management of patients with HIV or AIDS. BMJ : British Medical Journal, 322(7301), 1533–1535.

Cohen, S., & Willis, T. (1985). Stress, social support, and the buffering hypothesis. Psychol Bull, Sep;98(2):310-57.

Conversano, C. (2019). Common Psychological Factors in Chronic Diseases. Frontiers in Psychology, 10.

Cummings, B., Gutin, S. A., Jaiantilal, P., Correia, D., Malimane, I., & Rose, C. D. (2014). The Role of Social Support Among People Living with HIV in Rural Mozambique. AIDS Patient Care and STDs, 28(11), 602–612.

Deribew, A., Deribe, K., Reda, A. A., Tesfaye, M., Hailmichael, Y., & Maja, T. (2013). Do common mental disorders decline over time in TB/HIV co-infected and HIV patients without TB who are on antiretroviral treatment? BMC Psychiatry, 13(1), 174.

Dessalegn, N. G., Hailemichael, R. G., Shewa-amare, A., Sawleshwarkar, S., Lodebo, B., Amberbir, A., & Hillman, R. J. (2019). HIV Disclosure: HIV-positive status disclosure to sexual partners among individuals receiving HIV care in Addis Ababa, Ethiopia. PLOS ONE, 14(2), e0211967.

Duko, B., Toma, A., Asnake, S., & Abraham, Y. (2019). Depression, Anxiety and Their Correlates Among Patients With HIV in South Ethiopia: An Institution-Based Cross-Sectional Study. Frontiers in Psychiatry, 10.

Eker, D., & Arkar, H. (1995). Perceived social support: Psychometric properties of the MSPSS in normal and pathological groups in a developing country. Social Psychiatry and Psychiatric Epidemiology, 30(3), 121–126.

Fang, L., Chuang, D.-M., & Al-Raes, M. (2019). Social support, mental health needs, and HIV risk behaviors: A gender-specific, correlation study. BMC Public Health, 19(1), 1–8.

Girum, T., Wasie, A., Lentiro, K., Muktar, E., Shumbej, T., Difer, M., Shegaze, M., & Worku, A. (2018). Gender disparity in epidemiological trend of HIV/AIDS infection and treatment in Ethiopia. Archives of Public Health, 76(1), 51.

Gupta, R., Dandu, M., Packel, L., Rutherford, G., Leiter, K., Phaladze, N., Korte, F. P., Iacopino, V., & Weiser, S. D. (2010). Depression and HIV in Botswana: A Population-Based Study on Gender-Specific Socioeconomic and Behavioral Correlates. PLoS ONE, 5(12), e14252.

Herek, G. M., Saha, S., & Burack, J. (2013). Stigma and Psychological Distress in People With HIV/AIDS. Basic and Applied Social Psychology, 35(1), 41–54.

Herrmann, S., McKinnon, E., Hyland, N. B., Lalanne, C., Mallal, S., Nolan, D., Chassany, O., & Duracinsky, M. (2013). HIV-related stigma and physical symptoms have a persistent influence on health-related quality of life in Australians with HIV infection. Health and Quality of Life Outcomes, 11(1), 56.

Hoffman, S., Tymejczyk, O., Kulkarni, S., Lahuerta, M., Gadisa, T., Remien, R. H., Melaku, Z., Nash, D., & Elul, B. (2017). Brief Report: Stigma and HIV Care Continuum Outcomes Among Ethiopian Adults Initiating ART. JAIDS Journal of Acquired Immune Deficiency Syndromes, 76(4), 382–387.

Igwe, M. N., Ndukuba, A. C., Olose, E. O., Obayi, N. O., Ajayi, N. A., Odo, A., Njoku, P. O., Amadi, K. U., Ezeme, M. S., & Aguocha, C. (2016). Psychological distress and quality of life of people living with HIV/AIDS in a Nigerian teaching hospital. Mental Health, Religion & Culture, 19(9), 961–971.

Iliyasu, Z., Arotiba, J. T., & Babashani, M. (2004). Socio-demographic characteristics and risk factors among HIV/AIDS patients in Kano, Northern Nigeria. Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria, 13(3), 267–271.

Johnson, L. F., Mossong, J., Dorrington, R. E., Schomaker, M., Hoffmann, C. J., Keiser, O., Fox, M. P., Wood, R., Prozesky, H., Giddy, J., Garone, D. B., Cornell, M., Egger, M., Boulle, A., & for the International Epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) Collaboration. (2013). Life Expectancies of South African Adults Starting Antiretroviral Treatment: Collaborative Analysis of Cohort Studies. PLoS Medicine, 10(4), e1001418.

Judd, F. K., Cockram, A. M., Komiti, A., Mijch, A. M., Hoy, J., & Bell, R. (2000). Depressive symptoms reduced in individuals with HIV/AIDS treated with highly active antiretroviral therapy: A longitudinal study. The Australian and New Zealand Journal of Psychiatry, 34(6), 1015–1021.

Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S.-L. T., Manderscheid, R. W., Walters, E. E., & Zaslavsky, A. M. (2003). Screening for Serious Mental Illness in the General Population. Archives of General Psychiatry, 60(2), 184.

Kingori, C., Haile, Z. T., & Ngatia, P. (2015). Depression symptoms, social support and overall health among HIV-positive individuals in Kenya. International Journal of STD & AIDS, 26(3), 165–172.

Kinyanda, E., Hoskins, S., Nakku, J., Nawaz, S., & Patel, V. (2011). Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda. BMC Psychiatry, 11, 205.

Lam, P. K., Naar-King, S., & Wright, K. (2007). Social Support and Disclosure as Predictors of Mental Health in HIV-Positive Youth. AIDS Patient Care and STDs, 21(1), 20–29.

Liu, L., Pang, R., Sun, W., Wu, M., Qu, P., Lu, C., & Wang, L. (2013). Functional social support, psychological capital, and depressive and anxiety symptoms among people living with HIV/AIDS employed full-time. BMC Psychiatry, 13(1), 324.

Martino, G., Langher, V., Cazzato, V., & Vicario, C. M. (2019). Editorial: Psychological Factors as Determinants of Medical Conditions. Frontiers in Psychology, 10.

Matsumoto, S., Yamaoka, K., Takahashi, K., Tanuma, J., Mizushima, D., Do, C. D., Nguyen, D. T., Nguyen, H. D. T., Nguyen, K. V., & Oka, S. (2017). Social Support as a Key Protective Factor against Depression in HIV-Infected Patients: Report from large HIV clinics in Hanoi, Vietnam. Scientific Reports, 7.

Merlo, E. M. (2019). Opinion Article: The role of psychological features in chronic diseases, advancements and perspectives. Mediterranean Journal of Clinical Psychology, 7(3).

Meursing, K., & Sibindi, F. (2000). HIV counselling—A luxury or necessity? Health Policy and Planning, 15(1), 17–23.

Moskowitz, J. T., Carrico, A. W., Duncan, L. G., Cohn, M. A., Cheung, E. O., Batchelder, A., Martinez, L., Segawa, E., Acree, M., & Folkman, S. (2017). Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV. Journal of Consulting and Clinical Psychology, 85(5), 409–423.

Mthembu, J. C., Mabaso, M. L. H., Khan, G., & Simbayi, L. C. (2017). Prevalence of psychological distress and its association with socio-demographic and HIV-risk factors in South Africa: Findings of the 2012 HIV prevalence, incidence and behaviour survey. SSM - Population Health, 3, 658–662.

NACA. (2016). Fact Sheet- Women Girls Gender Equality and HIV in Nigeria.

Https:// (Fact-Sheet)


Obadeji, A., O. Ogunlesi, A., & O. Adebowale, T. (2014). Prevalence and Predictors of Depression in People living with HIV/AIDS Attending an Outpatient Clinic in Nigeria. Iranian Journal of Psychiatry and Behavioral Sciences, 8(1), 26–31.

Okonkwo, N. O., Larkan, F., & Galligan, M. (2016). An assessment of the levels of perceived social support among older adults living with HIV and AIDS in Dublin. SpringerPlus, 5(1), 726.

Olagunju, A. T., Adeyemi, J. D., Erinfolami, A. R., & Aina, O. F. (2012). HIV/AIDS and psychological distress: The experience of outpatients in a West African HIV clinic. HIV & AIDS Review, 11(1), 31–35.

Parcesepe, A., Tymejczyk, O., Remien, R., Gadisa, T., Kulkarni, S. G., Hoffman, S., Melaku, Z., Elul, B., & Nash, D. (2018). HIV-Related Stigma, Social Support, and Psychological Distress Among Individuals Initiating ART in Ethiopia. AIDS and Behavior, 22(12), 3815–3825.

Rasoolinajad, M., Abedinia, N., Noorbala, A. A., Mohraz, M., Badie, B. M., Hamad, A., & Sahebi, L. (2018). Relationship Among HIV-Related Stigma, Mental Health and Quality of life for HIV-Positive Patients in Tehran. AIDS and Behavior, 22(12), 3773–3782.

Reich, W. A., Lounsbury, D. W., Zaid-Muhammad, S., & Rapkin, B. D. (2010). Forms of social support and their relationships to mental health in HIV-positive persons. Psychology, Health & Medicine, 15(2), 135–145.

Remien, R. H., Stirratt, M. J., Nguyen, N., Robbins, R. N., Pala, A. N., & Mellins, C. A. (2019). Mental health and HIV/AIDS: The need for an integrated response. AIDS, 33(9), 1411–1420.

Rueda, S., Mitra, S., Chen, S., Gogolishvili, D., Globerman, J., Chambers, L., Wilson, M., Logie, C. H., Shi, Q., Morassaei, S., & Rourke, S. B. (2016). Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open, 6(7), e011453–e011453.

Sampasa-Kanyinga, H., Zamorski, M. A., & Colman, I. (2018). The psychometric properties of the 10-item Kessler Psychological Distress Scale (K10) in Canadian military personnel. PloS One, 13(4), e0196562.

Schmitz, M. F., & Crystal, S. (2000). Social Relations, Coping, and Psychological Distress Among Persons With HIV/AIDS1. Journal of Applied Social Psychology, 30(4), 665–685.

Serovich, J. M., Kimberly, J. A., Mosack, K. E., & Lewis, T. L. (2001). The role of family and friend social support in reducing emotional distress among HIV-positive women. AIDS Care, 13(3), 335–341.

Settineri, S., Frisone, F., Merlo, E. M., Geraci, D., & Martino, G. (2019). Compliance, adherence, concordance, empowerment, and self-management: Five words to manifest a relational maladjustment in diabetes. Journal of Multidisciplinary Healthcare, 12, 299.

Shannon, K., Leiter, K., Phaladze, N., Hlanze, Z., Tsai, A. C., Heisler, M., Iacopino, V., & Weiser, S. D. (2012). Gender inequity norms are associated with increased male-perpetrated rape and sexual risks for HIV infection in Botswana and Swaziland. PloS One, 7(1), e28739.

Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007). Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science & Medicine (1982), 64(9), 1823–1831.

Skinner, D., & Mfecane, S. (2004). Stigma, discrimination and the implications for people living with HIV/AIDS in South Africa. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 1(3), 157–164.

Stevelink, S. a. M., van Brakel, W. H., & Augustine, V. (2011). Stigma and social participation in Southern India: Differences and commonalities among persons affected by leprosy and persons living with HIV/AIDS. Psychology, Health & Medicine, 16(6), 695–707.

Tesfaye, S. H., & Bune, G. T. (2014). Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia. Global Health Action, 7(1), 23882.

Tlhajoane, M., Eaton, J. W., Takaruza, A., Rhead, R., Maswera, R., Schur, N., Sherr, L., Nyamukapa, C., & Gregson, S. (2018). Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe. AIDS and Behavior, 22(5), 1485–1495.

Travaglini, L. E., Himelhoch, S. S., & Fang, L. J. (2018). HIV Stigma and Its Relation to Mental, Physical and Social Health Among Black Women Living with HIV/AIDS. AIDS and Behavior, 22(12), 3783–3794.

Tsai, A. C., & Subramanian, S. V. (2012). Proximate context of gender-unequal norms and women’s HIV risk in sub-Saharan Africa. AIDS (London, England), 26(3), 381–386.

Vreeman, R. C., Scanlon, M. L., McHenry, M. S., & Nyandiko, W. M. (2015). The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children. Journal of the International AIDS Society, 18(7 (Suppl 6)).

Wang, H., Wolock, T. M., Carter, A., Nguyen, G., Kyu, H. H., Gakidou, E., Hay, S. I., Mills, E. J., Trickey, A., Msemburi, W., Coates, M. M., Mooney, M. D., Fraser, M. S., Sligar, A., Salomon, J., Larson, H. J., Friedman, J., Abajobir, A. A., Abate, K. H., … Murray, C. J. L. (2016). Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: The Global Burden of Disease Study 2015. The Lancet HIV, 3(8), e361–e387.

Yi, S., Chhoun, P., Suong, S., Thin, K., Brody, C., & Tuot, S. (2015). AIDS-Related Stigma and Mental Disorders among People Living with HIV: A Cross-Sectional Study in Cambodia. PLoS ONE, 10(3).

Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30–41.



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