Factors contributing to common psychological disorders among patients with HIV in Infectious Disease Clinic Hospital Sungai Buloh / Dr. Nor Hidayah Jaris

Background: Human Immunodeficiency Virus (HIV) infection is a life-threatening illness if left untreated. Patients with HIV are exposed to multiple social challenges such as stigma and abandonment that predispose them in development of psychological disorders that may lessen the treatment adherence and quality of life. Objective: This study aimed to determine the prevalence and the contributing factors of common psychological disorders among patients with HIV in Infectious Disease Clinic, Hospital Sungai Buloh. Methodology: This is a cross-sectional study involving 210 patients with HIV who are receiving Highly Active Antiretroviral Therapy (HAART) in Infectious Disease Clinic, Hospital Sungai Buloh. We recruited patients who fulfilled the inclusion criteria and gave informed consent. Socio-demographic characteristics and clinical factors such as side effects and substance use obtained from an interview with the patient. Other clinical factors were traced from the hospital electronic record system. Visual analogue scale (VAS), Hospital Anxiety Depression Scale (HADS) and Multidimensional Scale of Perceived Social Support (MSPSS) were given to the participant. The participant who scored 8 and above for HADS was interviewed using Mini International Neuropsychiatric Interview (M.I.N.I) to determine the diagnosis of generalized anxiety disorder (GAD) or major depressive disorder (MDD). Results: Prevalence of GAD among patients with HIV was 13%, MDD was 12.9% and both GAD and MDD was 7%. In multivariate analysis, illicit substance use in the past (AOR=4.17; p=0.003; 95% CI=1.56-9.44) and a low and moderate level of social support from significant others (AOR=3.73; p=0.002; 95% CI=1.66-10.04) showed consistent significant associations with GAD. CD4 counts more than 350 cells/ul (AOR=0.31; p=0.03; 95% CI= 0.11-0.86), amphetamine-type stimulants use for the past three months (AOR= 40.23; p=0.01; 95% CI=3.61-447.86), low and moderate level social support from significant others (AOR=4.36; p=0.02; 95% CI=1.22-15.64) and family (AOR= 5.65; p=0.01; 95% CI=1.43-22.38) were persistently significant associated with MDD. CD4 counts more than 350 cells/ul (AOR=0.17; p=0.01; 95% CI= 0.05-0.60), illicit substance use for the past three months (AOR= 24.08; p=0.01; 95% CI=2.41-240.98), low and moderate level social support from family (AOR=19.70; p=0.01; 95% CI=2.42-160.19) were significantly associated with both GAD and MDD. Conclusion: Low and moderate level of social support from significant others and illicit substance use in the past are the contributing factors of GAD among patients with HIV receiving HAART. Amphetamine-type stimulants use for the past three months, low and moderate level of social support from family and significant others as well as CD4 counts less than 350 cells/ul are the contributing factors of MDD among patients with HIV receiving HAART. CD4 counts less than 350 cells/ul, low and moderate level social support from the family and the use of illicit substance in the past contributes to both GAD and MDD among patients with HIV receiving HAART.