Socio-economic inequality in HIV-related perceived stigma, mental health, and quality of life among people living with HIV in Iran: a cross-sectional study

Abstract

Background: Socio-economic inequality is one of the most important issues in public health. This study aimed to assess socio-economic inequalities resulting from human immunodeficiency virus (HIV)related perceived stigma, mental health, and quality of life (QoL) among people living with HIV (PLHIV) in Markazi Province, Iran. Material and methods: This cross-sectional study included PLHIV in Markazi Province in 2019. An 12-item perceived stigma, general health questionnaire, and WHOQOL-HIV BREF questionnaire were administered to measure the perceived stigma, mental health, and QoL among PLHIV. Asset-based approach and principal component analysis were used to assess the socio-economic status (SES) of participants. Finally, concentration indices and 95% CI (confidence interval) were calculated to evaluate inequality among PLHIV. Results: A total of 123 PLHIV older than 18 years participated in the study. The mean age of participants was 41.1 (SD = 10.2) years, 66% of whom were males. The results of the study revealed that concentration indices were 0.03 (95% CI: 0.01-0.04%; p = 0.001) for perceived stigma, –0.21 (95% CI: –0.34 to –0.07%; p = 0.002) for mental disorders, and 0.07 (95% CI: 0.06-0.09%; p = 0.001) for QoL. Conclusions: The findings indicated that SES inequalities resulting from perceived stigma, QoL, and mental disorders are high among PLHIV. It was observed that, although perceived stigma was a critical issue among PLHIV with higher SES, low QoL and mental disorders were important factors among those with lower SES. Therefore, policy-makers in public health should be informed to plan and implement HIV-related strategies to decrease these inequalities.