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Di Gennaro F, Papagni R, Segala FV, Pellegrino C, Panico GG, Frallonardo L, Diella L, Belati A, Santoro CR, Brindicci G, Balena F, Bavaro DF, Montalbò D, Guido G, Calluso L, Di Tullio M, Sgambati M, Fiordelisi D, De Gennaro N, Saracino A. Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study. BMC Infect Dis 2024; 24:423. [PMID: 38649892 PMCID: PMC11034033 DOI: 10.1186/s12879-024-09315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact - although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) - PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. METHODS From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. RESULTS 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06-4.35]), family stigma (2.42 [1.65-3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. CONCLUSIONS In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.
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Affiliation(s)
- Francesco Di Gennaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Roberta Papagni
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Vladimiro Segala
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy.
| | - Carmen Pellegrino
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Gianfranco Giorgio Panico
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Luisa Frallonardo
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Diella
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Alessandra Belati
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Carmen Rita Santoro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Gaetano Brindicci
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Flavia Balena
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Domenico Montalbò
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy
| | - Giacomo Guido
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | | | | | - Margherita Sgambati
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy
| | - Deborah Fiordelisi
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Nicolò De Gennaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Annalisa Saracino
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
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