The prevalence of anxiety disorders among people living with HIV in India: A systematic review and meta-analysis
Aninda Debnath, Thejas Achary, Anubhav Mondal, Pritam Halder, Ashlyn Tom, Sayan Saha, Abu Talha PurkaitABSTRACT
Background:
Globally, 301 million face anxiety disorders, notably common among people living with human immunodeficiency virus (PLHIV), causing major challenges and reduced quality of life.
Aim:
This review assesses India’s prevalence, offering evidence to guide targeted interventions.
Methods:
A systematic literature search was conducted across PubMed, Excerpta Medica database (EMBASE), Scopus, and Web of Science up to November 2024. Observational studies using validated tools to assess anxiety prevalence in PLHIV were included. The pooled prevalence of anxiety disorders was estimated using a random-effects meta-analysis. Subgroup and sensitivity analyses were conducted to explore sources of heterogeneity. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Between-study heterogeneity was evaluated using Cochran’s Q and I² statistics.
Results:
Fifteen studies (5,336 PLHIV) were included. The pooled prevalence of anxiety was 36% (95% confidence interval: 24%–47%), with higher prevalence in hospital-based studies (39%) compared to community-based studies (23%). Females had a higher prevalence (46%) than males (36%), though this difference was not statistically significant. Diagnostic tools influenced prevalence estimates, with self-report measures (e.g., Hospital Anxiety and Depression Scale [HADS] and Depression Anxiety and Stress Scale [DASS]) reporting higher prevalence (48%–49%) than structured interviews (ICD-10: 7%, DSM-IV: 1%). Subgroup analysis revealed significant heterogeneity across study settings and diagnostic tools.
Conclusion:
This meta-analysis demonstrates a high prevalence of anxiety disorders among PLHIV in India, underscoring the need for integrated mental health services within HIV care frameworks. Routine anxiety screening, stigma reduction initiatives, and gender-sensitive interventions are essential to address this mental health burden effectively. Future research should focus on longitudinal outcomes and community-based approaches to improve mental health care for PLHIV.