Journal Article

Mental health disorders among people living with human immunodeficiency virus on antiretroviral therapy in Benin: the overlooked role of sleep quality

Alogou, Adébiyi Raphaël K, Ale, Boni Maxime, Dansou, Eugénie, Kouanou, Angèle Azon, Ale, Franck Biaou Guy, Wakaba, Nelly Njeri, Assogba, Calixte Oswald, Koutangni, Oswald Lionel, Agbodande, Kouessi Anthelme, Ale, Olushina Ayo Junior, Youm, Eric, Akpi, Simon Giscard, Assogba, Houénoudé Mickaël Arnaud, Damassoh, Kenneth Geovania Dèlonou

2026

Overview

Depression and anxiety are common comorbidities among people living with HIV (PLHIV) and may be influenced by sleep quality; evidence from Benin remains limited. We assessed the prevalence of depression and anxiety among PLHIV on antiretroviral therapy (ART) and evaluated their association with sleep quality. We conducted a hospital-based cross-sectional study at Benin's National Teaching Hospital from December 2023 to February 2024. Adults on ART ≥ 6 months were randomly sampled from the clinic registry. Validated tools were used: Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, moderate-or-worse threshold ≥ 10; Pittsburgh Sleep Quality Index, poor sleep > 5. Multivariable logistic regression identified factors independently associated with depression and anxiety. Among 312 participants (68.3% female; mean age 44.3 ± 12.3 years), the prevalence of depression and anxiety was 20.8% (n/N = 65/312) and 12.8% (n/N = 40/312), respectively; poor sleep quality was common (57.1%, n/N = 178/312). Good sleep quality was independently protective for both depression with adjusted odds ratio (aOR) = 0.3, 95% confidence interval (CI) = 0.2-0.6 and anxiety (aOR = 0.4; 95% CI = 0.2-0.9). Age ≥ 44 years was associated with higher odds of anxiety (aOR = 2.1; 95% CI = 1.0-4.5), while other sociodemographic and clinical covariates were not independently associated. Moderate-or-worse depressive and anxiety symptoms are frequent among PLHIV in this setting, and sleep quality shows a robust independent association with both outcomes. Integrating routine mental-health and sleep screening with clear referral pathways within ART services is warranted; longitudinal and interventional studies should test whether improving sleep reduces symptoms and enhances ART outcomes.

• Publisher: Edinburgh University Global Health Society,International Society for Global Health
• Subject: Acquired immune deficiency syndrome / Adult / AIDS / Anti-Retroviral Agents - therapeutic use / Antiretroviral agents / Anxiety - epidemiology / Benin - epidemiology / Cross-Sectional Studies / Depression - epidemiology / Female / HIV / HIV Infections - drug therapy / HIV Infections - epidemiology / HIV Infections - psychology / Human immunodeficiency virus / Humans / Male / Medical screening / Mental depression / Mental health / Middle Aged / Prevalence / Sleep / Sleep Quality