Anxiety, depression and neurocognitive disorder among HIV-infected people in penitentiary institutions of Azerbaijan.

Abstract

Purpose: This study aims to assess neurocognitive impairment, depression and anxiety level in HIV-infected individuals in penitentiary institutions of Azerbaijan.

Design/methodology/approach: A cross-sectional design was used to recruit incarcerated individuals in penitentiary institutions of Azerbaijan meeting the inclusion criteria (diagnosed with HIV). Participants completed standardized assessments to screen anxiety and depression symptoms, hospital anxiety and depression scale and neurocognitive functioning and mini mental status examination. Demographic and clinical data, including age, gender, HIV disease progression, antiretroviral therapy adherence, history of substance abuse and duration of incarceration, were also collected as covariates of interest. The study was approved by Azerbaijan Medical University Ethics Committee (P.23 / 19.05.2022). Data were analyzed using student-Bonferroni and H-Kruskal-Wallis tests. Variance analysis was conducted using the ANOVA test, while discriminant analyses involved the χ2-Pearson test, through SPSS software, version 26.

Findings: Of the 88 HIV positive patients who agreed to participate, 99% were male, with a median age of 44 years (range: 30-62), median CD4 count 453.1 cells/µl (range: 153-1,290). The prevalence of HIV-associated neurocognitive disorder was 72.7%. Occurrence of comorbid depression and anxiety symptoms was found to be 72% and 67%, respectively. Most patients (59.1%) were HIV-positive for more than five years. Increased depression and anxiety levels were identified mostly in first two years after admission to prison (p < 0.05). HIV-associated neurocognitive disorder was most commonly found among depressed patients (p = 0.009).

Originality/value: The findings of this study provide valuable insights into the cooccurrence and interrelationships between anxiety, depression and neurocognitive disorders in individuals with HIV in prisons. It highlights the unique intersection of HIV infection, mental health challenges and incarceration in a country where research on HIV-related issues in prisons is still developing. Ultimately, this study seeks to contribute to identify targeted interventions that address the mental health needs of incarcerated individuals living with HIV in Azerbaijan, promoting their overall well-being and quality of life.