Depression and anxiety symptoms and their psychosocial and functional correlates among people living with HIV attending two urban clinics in Panama

Abstract

Depression and anxiety disorder (GAD) symptoms are common among people living with HIV (PLHIV). In Panama, despite a growing epidemic and 20 antiretroviral clinics, only eight have integrated institutional mental healthcare. This study examined depression and GAD symptom levels and psychosocial correlates among PLHIV who attended two urban clinics. From August–November 2024, participants self-administered a questionnaire with PHQ-9 and GAD−2 instruments. Hierarchical logistic regression analyses identified associations with demographics, HIV care, psychosocial stressors and health-related functioning variables. Of the 317 participants, 31.0% identified as women, 50.8% men, and 17.4% non-binary/another gender. Moderate to severe depressive symptoms were reported by 16.1%, and high GAD symptoms by 20.4%. Depressive symptoms were associated with younger age (AOR = 0.89, 95%CI[0.81,0.98]), drug use (AOR = 7.77,95%CI[1.28,46.98]), discrimination (AOR = 5.86,95%CI[1.33, 25.79]), chronic pain (AOR=15.20,95%CI[2.44,94.37]) and difficulties with activities (AOR = 51.41,95%CI[4.98,530.61]). GAD symptoms were associated with insufficient resources (AOR = 5.02,95%CI[1.60, 15.77]), ART clinic (0.23[0.06, 0.82]), discrimination (AOR = 5.84,95%CI[1.86,18.29]), chronic pain (AOR = 8.80, 95%CI[1.92,40.39]) and difficulties with activities (AOR = 14.48,95%CI[1.79,116.92]). The findings highlight the mental health burden among PLHIV in Panama. Discrimination, chronic pain and activity limitations are associated with depression and GAD symptoms. Our results underscore the need for enhanced integrated mental healthcare in all clinics and community-based psychosocial support.