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PLoS One. 2019 Jan 24;14(1):e0210412. doi: 10.1371/journal.pone.0210412. eCollection 2019.

Anxiety symptoms and felt stigma among young people living with perinatally or behaviourally-acquired HIV in Ukraine: A cross-sectional survey.

Author information

1
Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.
2
Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine.
3
MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, United Kingdom.
4
Perinatal Prevention of AIDS Initiative, Odessa, Ukraine.
5
The Public Health Center of the Ministry of Health of Ukraine, Kiev, Ukraine.
6
Institute of Epidemiology and Infectious Diseases of NAMS, Kiev, Ukraine.

Abstract

BACKGROUND:

Ukraine has the second largest European HIV epidemic. This study aimed to describe stigma, demographic and social factors and their association with anxiety among perinatally and behaviourally-HIV-infected (PHIV; BHIV) young people in Kiev and Odessa.

METHODS:

104 PHIV and 100 BHIV young people aged 13-25 years completed a confidential tablet-based survey. Survey tools included the Hospital Anxiety and Depression Scale (HADS) (anxiety sub-scale scores of 8-10 indicating mild and ≥11 moderate/severe symptoms in last 7 days), Rosenberg Self-Esteem Scale (RSES) and HIV Stigma Scale (HSS) (short version, composite of disclosure, negative self-image and public attitudes sub-scales). Unadjusted Poisson regression models were fitted to explore factors associated with moderate/severe anxiety symptoms.

RESULTS:

PHIV and BHIV young people were of median age 15.5 [IQR 13.9-17.1] and 23.0 [21.0-24.3] years, having registered for HIV care a median 12.3 [10.3-14.4] and 0.9 [0.2-2.4] years previously; 97% (97/100) and 66% (65/99) respectively were on ART. Overall 43% (95%CI 36-50%) reported any and 13% (95%CI 9-19%) moderate/severe anxiety symptoms, with no difference by HIV acquisition mode (p = 0.405) or gender (p = 0.700). 42% (75/180) reported history of an emotional health problem for which they had not been referred/attended for care. Moderate/severe anxiety symptoms were associated with HIV-related stigma (prevalence ratio (PR) 1.24 95%CI 1.14-1.34 per HSS unit increase), lower self-esteem (PR 0.83 95%CI 0.78-0.90 per RSES point increase), CD4 ≤350 cells/mm3 (PR 2.29 95%CI 1.06-4.97), having no-one at home who knew the respondent's HIV status (PR 9.15 95%CI 3.40-24.66 vs all know) and, among BHIV, less stable living situation (PR 6.83 95%CI 1.99-23.48 for ≥2 vs no home moves in last 3 years) and history of drug use (PR 4.65 95%CI 1.83-11.85).

CONCLUSIONS:

Results indicated unmet need for psychosocial support. Further work is needed to explore strategies for mental health support, particularly around disclosure, self-esteem and stigma.

Conflict of interest statement

Claire Thorne reports personal fees from ViiV Healthcare for Advisory Board attendance, grants from ViiV Healthcare via PENTA Foundation and from AbbVie, Public Health England, European Commission H2020 and PENTA Foundation outside the submitted work; Ali Judd reports grants from Abbvie, Bristol Myers Squibb, Gilead, Janssen Pharmaceuticals and ViiV Healthcare through the PENTA Foundation, and from the Collaborative Initiative for Paediatric HIV Education and Research, Gilead Sciences, NHS England, Medical Research Council and PENTA Foundation outside the submitted work. Heather Bailey reports personal fees from Public Health England; the other authors have no conflicts of interest to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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