Abstract
Data are lacking on the psychiatric and psycho-social profiles of Middle-Eastern people living with HIV (PLHIV). Our study aimed to establish the prevalence and correlates of mental illness in a sample of Lebanese PLHIV, and to delineate their socio-cultural reality. PLHIV, either attending a private ID clinic or a non-governmental organization, were interviewed. A total of 94 patients were included. Sixty-nine (73.4%) were found to have at least one psychiatric disorder. Only nine participants were currently receiving psychotropic medications. The most common diagnosis was major depression, occurring in half of the subjects. Homosexual or bisexual orientation predicted the presence of a current depression (p = 0.024), and ART status was negatively associated with current depression (p = 0.028). The rate of psychiatric disorders is clearly higher than that of the general population. PLHIV with a homosexual or bisexual orientation face a double stigma, perhaps making them more vulnerable to depression. Our findings need to be replicated in larger studies with more representative samples.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
The data that support the findings of this study are available on request from the corresponding author SAK. The data are not publicly available due privacy and ethical restrictions.
Change history
17 June 2021
A Correction to this paper has been published: https://doi.org/10.1007/s10597-021-00858-x
References
Abboud, S., Noureddine, S., Huijer, H.A.-S., DeJong, J., & Mokhbat, J. (2010). Quality of life in people living with HIV/AIDS in Lebanon. AIDS Care, 22(6), 687–696
Adams, C., Zacharia, S., Masters, L., Coffey, C., & Catalan, P. (2016). Mental health problems in people living with HIV: Changes in the last two decades: The London experience 1990–2014. AIDS Care, 28(Suppl 1), 56–59
Akena, D., Musisi, S., Joska, J., & Stein, D. J. (2012). The association between aids related stigma and major depressive disorder among HIV-positive individuals in Uganda. PloS ONE, 7(11), e48671
Arseniou, S., Arvaniti, A., & Samakouri, M. (2014). HIV infection and depression. Psychiatry and Clinical Neurosciences, 68(2), 96–109
Bing, E. G., Burnam, M. A., Longshore, D., Fleishman, J. A., Sherbourne, C. D., London, A. S., Turner, B. J., et al. (2001). Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry, 58(8), 721–728
Charara, R., Forouzanfar, M., Naghavi, M., Moradi-Lakeh, M., Afshin, A., Vos, T., Daoud, F., et al. (2017). The burden of mental disorders in the eastern Mediterranean Region, 1990–2013. PLoS ONE, 12(1). Retrieved April 3, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240956/
Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., Angermeyer, M. C., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590
Freeman, M., Nkomo, N., Kafaar, Z., & Kelly, K. (2007). Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa. AIDS Care, 19(10), 1201–1209
Gökengin, D., Doroudi, F., Tohme, J., Collins, B., & Madani, N. (2016). HIV/AIDS: Trends in the Middle East and North Africa region. International Journal of Infectious Diseases: IJID: Official Publication of the International Society for Infectious Diseases, 44, 66–73
Hasse, B., Günthard, H. F., Bleiber, G., & Krause, M. (2005). Efavirenz intoxication due to slow hepatic metabolism. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 40(3), e22-23
Jallow, A., Ljunggren, G., Wändell, P., Wahlström, L., & Carlsson, A. C. (2017). HIV-infection and psychiatric illnesses—A double edged sword that threatens the vision of a contained epidemic: The Greater Stockholm HIV Cohort Study. The Journal of Infection, 74(1), 22–28
Kaplan, R. L., & El Khoury, C. (2016). The elephants in the room: Sex, HIV, and LGBT populations in MENA. Intersectionality in Lebanon comment on “Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward.” International Journal of Health Policy and Management, 6(8), 477–479
Karam, E. G., Mneimneh, Z. N., Dimassi, H., Fayyad, J. A., Karam, A. N., Nasser, S. C., Chatterji, S., et al. (2008). Lifetime prevalence of mental disorders in Lebanon: First onset, treatment, and exposure to war. PLoS Medicine, 5(4), e61
Karamouzian, M., Madani, N., Doroudi, F., & Haghdoost, A. A. (2016). Improving the quality and quantity of HIV data in the Middle East and North Africa: key challenges and ways forward. International Journal of Health Policy and Management, 6(2), 65–69
Khalaf, D. R., Hlais, S. A. A., Haddad, R. S., Mansour, C. M., Pelissolo, A. J., & Naja, W. J. (2014). Developing and testing an original Arabic religiosity scale. Middle East Current Psychiatry, 21(2), 127–138
Lebanese Ministry of Public Health. (2019). National AIDS Control Program in Lebanon. Retrieved April 3, 2021, from https://www.moph.gov.lb/en/Pages/2/4000/aids
Lipira, L., Williams, E. C., Nevin, P. E., Kemp, C. G., Cohn, S. E., Turan, J. M., Simoni, J. M., et al. (2019). Religiosity, social support, and ethnic identity: Exploring “Resilience Resources” for African-American women experiencing HIV-related stigma. Journal of Acquired Immune Deficiency Syndromes (1999), 81(2), 175–183
Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91(11), 1869–1876
Myer, L., Smit, J., Roux, L. L., Parker, S., Stein, D. J., & Seedat, S. (2008). Common mental disorders among HIV-infected individuals in South Africa: Prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care and STDs, 22(2), 147–158
Nachega, J. B., Morroni, C., Zuniga, J. M., Sherer, R., Beyrer, C., Solomon, S., Schechter, M., et al. (2012). HIV-related stigma, isolation, discrimination, and serostatus disclosure: A global survey of 2035 HIV-infected adults. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill.: 2002), 11(3), 172–178
Niu, L., Luo, D., Liu, Y., Silenzio, V. M. B., & Xiao, S. (2016). The mental health of people living with HIV in China, 1998–2014: A systematic review. PloS ONE, 11(4), e0153489
Passos, S. M. K., de Souza, L. D. M., & Spessato, B. C. . (2014). High prevalence of suicide risk in people living with HIV: Who is at higher risk? AIDS Care, 26(11), 1379–1382
Pence, B. W., Miller, W. C., Whetten, K., Eron, J. J., & Gaynes, B. N. (2006). Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the Southeastern United States. Journal of Acquired Immune Deficiency Syndromes (1999), 42(3), 298–306
Rasmussen, L. D., Obel, D., Kronborg, G., Larsen, C. S., Pedersen, C., Gerstoft, J., & Obel, N. (2014). Utilization of psychotropic drugs prescribed to persons with and without HIV infection: A Danish nationwide population-based cohort study. HIV Medicine, 15(8), 458–469
Rueda, S., Mitra, S., Chen, S., Gogolishvili, D., Globerman, J., Chambers, L., Wilson, M., et al. (2016). Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: A series of meta-analyses. BMJ open, 6(7), e011453
Scandlyn, J. (2000). When AIDS became a chronic disease. Western Journal of Medicine, 172(2), 130–133
Serovich, J. M., Kimberly, J. A., Mosack, K. E., & Lewis, T. L. (2001). The role of family and friend social support in reducing emotional distress among HIV-positive women. AIDS Care, 13(3), 335–341
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(Suppl 20), 22–33 quiz 34–57.
Turjanski, N., & Lloyd, G. G. (2005). Psychiatric side-effects of medications: Recent developments. Advances in Psychiatric Treatment, 11(1), 58–70
UNAIDS. (2020). UNAIDS data 2020. Retrieved April 3, 2021, from https://www.unaids.org/en/resources/documents/2020/unaids-data
VCT booklet-National AIDS Control Program in Lebanon. (n.d.). Retrieved from https://www.moph.gov.lb/userfiles/files/Prevention/NationalAIDSControlProgram/VCTBooklet23oct15.pdf
Weissman, M. M., Bland, R. C., Canino, G. J., Greenwald, S., Hwu, H. G., Joyce, P. R., Karam, E. G., et al. (1999). Prevalence of suicide ideation and suicide attempts in nine countries. Psychological Medicine, 29(1), 9–17
Acknowledgements
We thank Anwar el Mahabba for their technical assistance.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Contributions
SAK, WN, RH and JM designed the study. SAK, BM, NR, SA and CZ collected the data and drafted the original article. RB performed the statistical analysis. WN, RH and JM reviewed the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The original online version of this article was revised: the given name and surname of all the authors are swapped to present it correctly.
Rights and permissions
About this article
Cite this article
Abou Kassm, S., Naja, W., Haddad, R. et al. Lebanese People Living with HIV: Psychiatric Co-morbidities and Psycho-Social Environment. Community Ment Health J 57, 1400–1408 (2021). https://doi.org/10.1007/s10597-021-00834-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-021-00834-5