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BMC Public Health. 2012; 12: 463.
Published online Jun 21, 2012. doi:  10.1186/1471-2458-12-463
PMCID: PMC3444349
Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India – a community based cross sectional study
Bimal Charles,1 Lakshmanan Jeyaseelan,2 Arvind Kumar Pandian,3 Asirvatham Edwin Sam,corresponding author1 Mani Thenmozhi,2 and Visalakshi Jayaseelan2
1AIDS Prevention and Control Project, Voluntary Health Services, Adyar, Chennai, 600 113, India
2Department of Bio-Statistics, Christian Medical College and Hospital, Vellore, India
3USAID, New Delhi, India
corresponding authorCorresponding author.
Bimal Charles: bimalcharles/at/gmail.com; Lakshmanan Jeyaseelan: ljey/at/hotmail.com; Arvind Kumar Pandian: akumar/at/usaid.gov; Asirvatham Edwin Sam: aedwinsam/at/yahoo.com; Mani Thenmozhi: mani.thenmozhi/at/gmail.com; Visalakshi Jayaseelan: visali_pv/at/hotmail.com
Received November 2, 2011; Accepted June 21, 2012.
Abstract
Background
India has around 2.27 million adults living with HIV/AIDS who face several challenges in the medical management of their disease. Stigma, discrimination and psychosocial issues are prevalent. The objective of the study was to determine the prevalence of severe stigma and to study the association between this, depression and the quality of life (QOL) of people living with HIV/AIDS (PLHA) in Tamil Nadu.
Methods
This was a community based cross sectional study carried out in seven districts of Tamil Nadu, India, among 400 PLHA in the year 2009. The following scales were used for stigma, depression and quality of life, Berger scale, Major Depression Inventory (MDI) scale and the WHO BREF scale. Both Stigma and QOL were classified as none, moderate or severe/poor based on the tertile cut off values of the scale scores. Depression was classified as none, mild, moderate and severe. Logistic regression analyses were performed to study the risk factors.
Results
Twenty seven per cent of PLHA had experienced severe forms of stigma. These were severe forms of personalized stigma (28.8%), negative self-image (30.3%), perceived public attitude (18.2%) and disclosure concerns (26%). PLHA experiencing severe depression were 12% and those experiencing poor quality of life were 34%. Poor QOL reported in the physical, psychological, social and environmental domains was 42.5%, 40%, 51.2% and 34% respectively. PLHA who had severe personalized stigma and negative self-image had 3.4 (1.6-7.0) and 2.1 (1.0-4.1) times higher risk of severe depression respectively (p < .001). PLHA who had severe depression had experienced 2.7(1.1-7.7) times significantly poorer QOL.
Conclusions
Severe forms of stigma were equivalently prevalent among all the categories of PLHA. However, PLHA who had experienced severe depression had only developed poor QOL. A high level of social support was associated with a high level of QOL.
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