PLHIV are more likely to have mental distress: evidence from a comparison of a cross-section of HIV and diabetes patients at Tertiary Hospitals in Nigeria

HIV is now regarded as a chronic disease because of the availability of treatment. However, it is not well known if there are differences (clinically and in magnitude) between the mental health status of PLHIV and people living with other chronic diseases. The aim of this study was to compare the mental health status of patients attending antiretroviral clinics to patients attending diabetes clinics at tertiary hospitals in Ogun State, Nigeria. A comparative hospital-based cross-sectional study of mental distress among 639 HIV-positive and 639 diabetic patients was carried out. Multivariate logistic regression analysis was used to control for confounders and to predict the probability of mental distress in PLHIV. The mean age of the participants was 44.87 ( 13.83) years and it had a range of 63 years (17 to 80). The prevalence of mental distress was higher among HIV-positive participants (46.79%) than diabetic participants (33.02%) (p<0.0001). HIV-positive participants had greater odds of mental distress than diabetics (odds ratio=1.78; 95% CI=1.41-2.25). HIV-positivity, female sex, lower levels of education, being unemployed, poorer housing conditions and separated, widowed or divorced were associated with higher odds of mental distress (p<0.05). Mental distress was predicted by HIV-positivity, occupation and current marital status. HIV infection and social inequalities are independent risk factors for mental distress. The odds of having mental distress is higher among PLHIV compared with diabetic patients. Addressing social inequalities might be the critical factor in the control of mental distress among PLHIV.Abbreviations: ART: Anti-retroviral therapy; CI: Confidence interval; YLD: Years Lived with Disability; GHQ: General Health Questionnaire; HIV/AIDS: Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome; LMIC: Low and middle-income countries; MH: Mantel-Haenszel; PLHIV: People living with HIV; ROC: Receiver operating characteristic