Evidence map›Paper›PMID 40764611›Full record

ArticleHIV medicine2025

Stigma, depression and pillbox return among adults living with HIV in rural Tanzania: A prospective cohort study.

Robert Ndege, James Okuma, Bernard Kivuma, Raphael Magnolini, Leila Samson, Ezekiel Luoga, Elizabeth Senkoro, Olivia Kitau, Fiona Vanobberghen, Daniel H Paris and 2 more

Abstract read
In one paragraph

Article in HIV medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Advances in Treatment of Psychiatric Disorders in Patients with HIV.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Robert NdegeBiomedical Research and Clinical Trials Department, Ifakara Health Institute, Ifakara, Tanzania.
James OkumaDepartment of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
Bernard KivumaBiomedical Research and Clinical Trials Department, Ifakara Health Institute, Ifakara, Tanzania.
Raphael MagnoliniArud Centre for Addiction Medicine, Zurich, Switzerland.
Leila SamsonBiomedical Research and Clinical Trials Department, Ifakara Health Institute, Ifakara, Tanzania.
Ezekiel LuogaBiomedical Research and Clinical Trials Department, Ifakara Health Institute, Ifakara, Tanzania.
Elizabeth SenkoroKilimanjaro Christian Medical Center, Moshi, Tanzania.
Olivia KitauBreakthrough Cancer Research, Charities Institute Ireland, Dublin, Ireland.
Fiona VanobberghenDepartment of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
Daniel H ParisDepartment of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
Maja WeisserBiomedical Research and Clinical Trials Department, Ifakara Health Institute, Ifakara, Tanzania.
KIULARCO Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStigma remains a major barrier to accessing HIV care. We analysed the association between stigma and failed pillbox return, and described factors associated with stigma among adults living with HIV in rural Tanzania.

methodsFrom the Kilombero and Ulanga Antiretroviral Cohort we included newly diagnosed adults ≥15 years enrolled between June 2019 and September 2022 with a stigma assessment at 6-12 months and a clinical visit within 7 days. We assessed stigma using the adapted 7-item Berger questionnaire. Logistic and linear regression models were used to identify factors associated with stigma and to determine the association between stigma and depression with failed pillbox return.

resultsAmong 241 participants (median age 37 years (IQR, 30-44) at enrolment), most were female (n = 170, 71%), WHO stage I (n = 132, 55%), had no pillbox at the clinical visit (n = 188, 78%), and remained in care at 2 years (n = 167, 69%). Participants with no pillbox had slightly higher stigma levels (9, IQR, 5-14) versus those who did (7, IQR, 4-13); this difference was not observed after adjustment (adjusted Odds Ratio 1.02 [95% CI 0.97, 1.07]; p = 0.38). Higher stigma was associated with higher depression (95% CI 0.48, 1.33, p < 0.01), HIV non-disclosure (95% CI 2.58, 8.33, p < 0.01) and higher education (p < 0.01). Higher Body Mass Index (p < 0.01) and advanced WHO stage (p < 0.01) were associated with lower stigma.

conclusionFailed pillbox return was not associated with stigma. However, stigma was associated with depression, HIV non-disclosure and higher education. Stigma-reduction interventions focused on mental health and disclosure are urgently needed in rural areas.

Indexed as

DepressionHIV InfectionsSocial StigmaAdultFemaleHumansMaleMiddle AgedProspective StudiesRural PopulationSurveys and QuestionnairesTanzaniaYoung Adultinternalized stigmaperceived stigmapillboxstigma depression

Identifiers

PMID40764611
PMCPMC12497930

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.