Introduction: Psychological distress (PD) affects treatment adherence and quality of life among people living with human immunodeficiency virus (PLHIV). Early antiretroviral therapy (ART) initiation and positive treatment experiences may reduce PD, yet evidence from Cameroon remains limited. This study assessed the association between ART initiation timing, treatment-related experiences, and PD among PLHIV in the Akonolinga Health District (AHD), Cameroon.
Methods: A cross-sectional study was conducted among 385 adults receiving human immunodeficiency virus (HIV) care at four treatment centres in the AHD. Psychological distress was measured using the Kessler-10 (K10) scale, with scores ≥25 indicating distress. ART initiation was categorised as early (≤30 days) or late (>30 days) post-diagnosis. Treatment-related experiences included presence of HIV symptoms, counselling, side effects, and belief in ART effectiveness. Multivariable logistic regression adjusted for socio-demographic and clinical covariates.
Results: The prevalence of psychological distress was 17.1%. Early ART initiation was strongly associated with reduced odds of PD (adjusted odds ratio [AOR] = 0.10; 95% CI: 0.03–0.38; p=0.001). Absence of HIV symptoms (AOR = 0.37; 95% CI: 0.14–0.93; p=0.035) and urban residence (AOR = 0.40; 95% CI: 0.16–0.99; p=0.047) were protective. Unmarried participants had higher odds of PD (AOR = 3.63; 95% CI: 1.22–10.82; p=0.021). Age, counselling, and belief in ART effectiveness were not statistically significant after adjustment.
Conclusion: Early ART initiation and absence of HIV symptoms are key factors associated with lower psychological distress among PLHIV. Integrating prompt ART initiation with routine mental health screening and targeted psychosocial support, particularly for unmarried and rural patients, may improve wellbeing and treatment outcomes in HIV programmes in Cameroon.