The Mental Wellbeing of Women living with HIV in South Africa: the Ndlovu Cohort Study

Abstract

Background: Prior research has shown that women in South Africa are more vulnerable to HIV infection due to gender inequalities. Additionally, people living with HIV (PLHIV) are more likely to suffer from mental illnesses than people who do not live with HIV. Furthermore, HIV-related stigma is considered to be a risk factor for mental illness among PLHIV. The socioeconomic position as well as relationship status also influence the mental health of PLHIV, and specifically women. This research will clarify the interplay between sex and mental health outcomes while analyzing whether sex causes differences in education, employment, and relationship status, which in turn may cause differences in HIV-related stigma which altogether may affect the mental health outcomes of PLHIV in South Africa. Methods: Using data from the baseline questionnaire of the Ndlovu cohort study conducted in Moutse area, South Africa, this study performs a serial multiple mediation analysis on 855 PLHIV following the four-step model by Baron & Kenny (1986). Results: No serial multiple mediation was observed. Relationship status is the only mediator between sex and mental health as the beta coefficient of sex decreased from B = - .080 (p =.011) to B = -.149 (p <.001). Conclusion: The findings indicated that women living with HIV are more likely to be in an unstable relationship and that it may increase mental health issues. As in patriarchal systems an unstable relationship may come with other disadvantages caused by gender inequalities, there may be many more reasons for increased mental health issues among women living with HIV. Therefore, it is important to continue research on this topic and implement policies and interventions to alleviate the mental burden on women living with HIV in South Africa.