Document Type


Publication Date

October 2015


Poor mental health functioning among persons living with HIV (PLHIV) has gained considerableattention particularly in low-income countries that disproportionately carry the global HIV/AIDSburden. Fewer studies, however, have examined the relationship between poverty indicators andmental health among PHLIV in India. Based on this cross-sectional study of 196 HIV-seropositiveadults who received medical services at Shalom AIDS Project in Delhi, India, structural equationmodeling and mediation analysis were employed to estimate the associations between povertyindices (household asset index, food security, unemployment, water treatment, sanitation), HIVhealthfactors (illness in the past 3 months, co-morbid medical conditions), and psychologicaldistress. In the final model, ownership of fewer household assets was associated with higherlevels of food insecurity, which in turn was associated with higher psychological distress. Also,the household asset index, food insecurity, and unemployment had a larger effect onpsychological distress than new opportunistic infections. These findings build on increasingevidence that support concerted efforts to design, evaluate, and refine HIV mental healthinterventions that are mainstreamed with livelihood programming in high poverty regions in India.