article · BMC Psychiatry
Adults living with HIV face elevated risks of generalised anxiety disorder, yet evidence regarding its burden in Tanzania has been limited. A cross-sectional investigation examined 593 adults receiving care across primary, secondary, and tertiary health clinics in the Kilimanjaro region using the standardised seven-item Generalized Anxiety Disorder assessment. Significant anxiety symptoms were identified in 12.48 percent of the participants. Statistical analysis revealed that the probability of experiencing notable anxiety was significantly higher among patients treated at tertiary facilities, individuals aged 25 to 44 years, those exhibiting high anxiety sensitivity, and those reporting higher levels of perceived social support. These findings point to a substantial mental health burden within this patient population and suggest that incorporating regular anxiety screening into routine clinic visits, alongside targeted education for patients and caregivers, could help address these unrecognised psychiatric symptoms.
Mental health conditions often go undetected in routine chronic illness management. Demonstrating that more than one in eight adults with HIV in this region suffers from significant anxiety highlights the urgent need to address psychological wellbeing alongside antiviral treatment. Identifying key associated factors allows healthcare programmes to better direct diagnostic resources and support to the most vulnerable patient groups.
The findings can inform public health managers, clinical software developers, and clinic operators looking to integrate routine GAD-7 screening protocols into existing HIV care workflows. The research represents early-stage epidemiological evidence, meaning direct commercial applications are limited, but it highlights a clear service need for validated digital screening tools and mental health support pathways in regional healthcare centres.
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BACKGROUND: People with human immunodeficiency virus (PWH) are more prone to generalized anxiety disorder. There is a limited understanding of the prevalence of significant anxiety symptoms and its associated risk factors among adult PWH in the Tanzanian context. This study aims to determine the prevalence of significant anxiety symptoms and related risk factors among adult PWH attending care and treatment clinics in Moshi Municipality, Kilimanjaro Region. METHODS: We used a multistage random cluster sampling approach to select participants at four Care and treatment centers (CTCs) of Kilimanjaro Christian Medical Centre, Mawenzi Regional Referral Hospital, Majengo, and Pasua Health Centre, by location at tertiary, secondary, and primary health care levels. The seven-item Generalized Anxiety Disorder (GAD-7) screening tool assessed levels of generalized anxiety symptoms with significance set at scores ≥ 10. Sociodemographic, clinical, and psychosocial characteristics were collected using a semi-structured questionnaire. Bivariate analyses determined factors associated with significant anxiety symptoms (GAD-7 ≥ 10) at p-values [Formula: see text]0.20 for inclusion in the multivariate model. Adjusted prevalence ratios with confidence intervals are reported with significance set at a p-value of < 0.05. RESULTS: Out of 593 PWH participants, 12.48% screened positive for significant anxiety symptoms. Participants treated at the tertiary health facility level (aPR = 2.91, 95% CI: 2.48-3.41, P-value = 0.001), early adulthood 25-44 years (aPR = 1.75, 95% CI: 1.27-2.42, P-value = 0.001), with higher anxiety sensitivity (aPR = 3.28, 95% CI: 2.08-5.19, P-value = 0.001), and higher levels of perceived social support (aPR = 2.09; 95% CI: 1.34-3.27, P-value = 0.001) showed a higher likelihood of significant generalized anxiety symptoms. CONCLUSIONS: Significant anxiety symptoms were common among adult PWH. Integrating routine generalized anxiety screening and raising PWH's and primary caregivers' awareness of GAD is recommended. TRIAL REGISTRATION: Clinical trial number not applicable.
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DOI: 10.1186/s12888-025-06769-5
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