The interplay of psychological distress, stigma, and social support in determining quality of life among Vietnamese people living with HIV.

Abstract

Introduction: This study explores the intersection of psychological distress, stigma, and social support among Vietnamese people living with HIV (PLWH), focusing on their impact on quality of life (QoL). While antiretroviral therapy (ART) enhances survival, stigma and mental health issues persist, undermining QoL. Addressing these gaps in Vietnam is critical for improving comprehensive HIV care.

Methods: A cross-sectional study was employed at Thu Duc City Hospital from March to May 2024, involving 369 PLWH receiving ART. Data collection utilized validated tools to assess anxiety symptoms (GAD-7), depressive symptoms (PHQ-9), perceived social support (MSPSS), HIV stigma (HSS), and health-related QoL (PozQoL). Structural equation modeling (SEM) was applied to examine interrelationships among these factors.

Results: The distribution of moderate or severe anxiety and depression was 6.8% and 2.1%, respectively. SEM analysis revealed that anxiety and depression significantly increased perceived stigma, while social support reduced it. Stigma negatively impacted QoL. Social support showed complex effects on QoL, depending on contextual factors. Viral load and weight also moderated stigma's impact on QoL.

Discussion: The findings underscore the bidirectional relationship between mental health and stigma, emphasizing the need for integrated mental health services within HIV care. Social support can mitigate stigma but requires careful contextual tailoring to avoid unintended negative consequences.

Conclusion: Enhancing QoL in PLWH necessitates addressing mental health, stigma, and social support. Integrating psychological care and stigma-reduction strategies into ART programs is vital. Future research should explore longitudinal dynamics and refine social interventions to maximize their benefits.