Depression and anxiety among people living with HIV on antiretroviral therapy: prevalence and correlates at the National Sexually Transmitted Diseases/AIDS programme, in Sri Lanka

A cross sectional study of 320 PLHIV used the validated Sinhala Hospital Anxiety and Depression Scale (HADS-S) and diagnostic interviews. Anxiety prevalence was 27.5% and depression 33.4%. Univariate analyses showed significant associations with female gender (anxiety p = 0.009; depression p < 0.001), low income (anxiety p = 0.005; depression p < 0.001), semi-urban residence (anxiety p = 0.003; depression p = 0.001), sexual minority/transgender identity (anxiety p < 0.001), sexual dysfunction (anxiety p = 0.001; depression p < 0.001), poor ART adherence (anxiety p < 0.001), marital status (anxiety p = 0.016; depression p < 0.001), non-disclosure (anxiety p = 0.008; depression p < 0.001), and suicidality (both p < 0.001). In multivariate regression, poor ART adherence predicted anxiety (OR = 16.45, 95% CI 6.48-41.75). Predictors of depression were HIV awareness > 1 year (OR = 10.10, 95% CI 1.16-87.76), female gender (OR = 3.32, 95% CI 1.42-7.77), marital status (married vs other, OR = 4.95, 95% CI 1.89-12.98), and income ≤ Rs.50,000 (OR = 2.74, 95% CI 1.35-5.56). Anxiety and depression correlated moderately (r = 0.319, p < 0.001). Only 8.1% received antidepressants despite 21.3% reporting suicidality.