Prevalence and factors associated with probable anxiety disorders among elderly persons living with HIV at Mulago ISS clinic: A cross-sectional study.

Introduction: Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major public health concern globally. Due to advancements in Anti-Retroviral Treatment (ART) therapy, more people with HIV are living longer with about 1.4 million infected people in Uganda. Anxiety disorders are often unrecognized and undetected in older persons living with HIV (PLWH) yet they impair an elderly person's physical health and decrease the ability to perform daily activities.

Objective: To determine the prevalence and factors associated with probable anxiety disorders among elderly PLWH at Mulago Immune Suppression Syndrome (ISS) clinic.

Methods: A cross-sectional study was conducted at Mulago ISS clinic among 273 systematically selected participants living with HIV/AIDS on antiretroviral therapy for at least 6 months between April and May 2024. Interviews were conducted using the Generalized Anxiety Disorder 7-item (GAD-7) screening tool to help identify individuals who may be at risk for anxiety disorders and structured questionnaires for socio-demographics, and psychological factors. Drug and clinical factors data were extracted from records, entered into Epidata, and later to STATA version 17 for analysis. Prevalence was reported as a percentage and modified Poisson regression analysis was used to determine the factors associated with anxiety disorders.

Results: We enrolled 273 participants with a median age (Interquartile range) was 56 (52, 61.5) years. 54.9% were females, 56.8% didn't have a partner and 53.8% were employed. The prevalence of probable anxiety disorders was 16.8% (95% CI 12.5-21.6). Employment status (aPR- 2.113, 95% CI 1.252-3.567), family history of mental health disorder (aPR-2.041, 95% CI 1.228-3.394), stigma (aPR-2.564, 95% CI 1.544-4.257) and family support (aPR-2.169, 95% CI 1.272-3.699) were significantly associated with having probable anxiety disorders.

Conclusion: One in every six elderly persons living with HIV may have a probable anxiety disorder. Being unemployed, having a family history of mental health disorders, having stigma and having inadequate family support were significantly associated with having a probable anxiety disorder. Healthcare workers should provide comprehensive anxiety screening and patient-centered care for elderly persons with HIV. At the same time, the government develops financial empowerment strategies and supports mental health through family groups, and public campaigns to reduce HIV stigma and educate families on effective support.