Prevalence of mental health problems in people living with HIV: a systematic review and meta-analysis

HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28-34) for depression, 29% (24-34) for anxiety, 20% (17-24) for suicidal ideation, 20% (13-28) for post-traumatic stress disorder, 47% (40-55) for stigma, 44% (31-56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV.