Correlates and consequences of internalized stigma of mental illness among people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in Nigeria, West Africa

Abstract

There is evidence that internalized stigma significantly impacts the lives of depressed people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA). Nevertheless, there is paucity of data on the extent, domains and demographic correlates of internalized stigma among PLWHA; hence the need for this study. This was a hospital based, cross sectional, descriptive study of one hundred and seventy depressed PLWHA. The PHQ-9 was used to screen for depression. The severity of the depression was classified as minimal, mild, moderate and severe. The three keys of social determinants of depression (SDS) were assessed and the association with stigma sought. A modified version of stigma of mental illness scale (ISMI) was used as a measure of their self stigma. The prevalence of depressive disorders was 57%. The spectrum of stigmatization was as follows, 103 (60.6%), minimal, 33 (19.4%), mildly, 19 (11.2%), moderately and 15 (8.8%) severely stigmatized. There was a strong association between stigma and age group, educational level, monthly income, stressful life events as well as social cohesion. Self-stigma is a common phenomenon in depressed PLWHA. It is not possible to manage PLWHA without considering the highly stigmatizing context in which they are embedded. Moreover, due to the high burden of depressive disorders and its association with AIDS related stigma, routine screening of PLWHA for both conditions is recommended.