Chengbin Zheng,1 Leilei Liang,1 Marhaba Kiyum,1 Tongshuang Yuan,1 Junsong Fei,1 Huimin Wang,1 Jiaying Gao,1 Xiaoying Liu,1 Songli Mei,1 Na Du2 

1Department of Social Medicine and Health Management, School of Public Health of Jilin University, Changchun, 130021, People’s Republic of China; 2Center of Infectious Disease and Pathogen Biology, Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, 130061, People’s Republic of China

Correspondence: Songli Mei, Jilin University, Department of Social Medicine and Health Management, School of Public Health of Jilin University, Changchun, 130021, People’s Republic of China, Email meisongli@sina.com Na Du, The First Hospital of Jilin University, Center of Infectious Disease and Pathogen Biology, Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, 130061, People’s Republic of China, Email du_na@jlu.edu.cn

Background: With the increasing popularity of ARVs, physical symptoms of people living with HIV/AIDS (PLWHA) have been effectively improved. Improving mental health and quality of life has gradually become the focus of attention in the treatment. The aim of this study is to explore the association between death anxiety and depression in men living with HIV/AIDS (MLWHA) from the perspective of network analysis.
Methods: This study recruited 701 MLWHA in Jilin Province, China. Participants were asked to complete a questionnaire. The average age of the participants was 37.4 years old. Among them, there were 54 heterosexual participants, 494 homosexual participants, 139 bisexual participants, and 14 asexual/other participants. Network analysis was used to identify central symptoms, key bridge symptoms, and the strongest edge among symptoms in the death anxiety and depression network.
Results: In this study, 18.1% of MLWHA may suffer from severe depression. The severity of depression in homosexual MLWHA was severer than in heterosexuals. Death anxiety was severer among unmarried and married/cohabiting MLWHA compared to divorced/separated/widowed MLWHA. This study found that item DAS10 (The topic of post death is very confusing to me) was the most central symptom. The edge DAS2 – PHQ9 (Rarely think of death – Suicide ideation) was the strongest edge between death anxiety and depression. Item DAS2 (Rarely think of death) was the strongest bridge symptom.
Conclusion: Psychological symptoms such as distress over the topic of death, thoughts of death, and suicidal ideation play an important influential and connecting role in the death anxiety-depression network among MLWHA. Implementing appropriate interventions for these symptoms—such as popularizing correct knowledge of death and providing more psychological counseling services for this group—can effectively reduce the co-occurrence of death anxiety and depression, thereby improving the mental health of MLWHA.

Keywords: death anxiety, depression, men living with HIV/AIDS, network analysis, comorbid psychological symptoms