Background: Cervical cancer (CC) remains the leading cause of cancer-related mortality among women in sub-Saharan Africa, disproportionately affecting women living with HIV (WLWH). Depression is common in both HIV and cancer populations, but the psychological burden among women with dual diagnoses is poorly studied in Tanzania. This study investigated socio-demographic, clinical and psychological factors associated with depression in WLWH and CC.
Methods: A cross-sectional study was conducted among 160 WLWH and CC, at least 3 months post CC treatment, between January and June 2024. Socio-demographic and clinical data were obtained from structured questionnaires and medical records. Depression prevalence and severity were assessed using the Patient Health Questionnaire. Perceived social support, HIV-related stigma and coping strategies were also measured using the tools were used in previous studies in Tanzania with good internal consistency. Multivariable linear regression was performed to identify independent predictors of depression.
Results: The median age of participants was 49 years (IQR: 10). Most were married (91.9%), unemployed (51.9%) and had primary education (90%). Older age (51–73 years) was significantly associated with higher depression scores compared to younger participants (p < 0.001). Poor perceived social support was a strong predictor of depression (p = 0.0007). Negative self-image, as a component of HIV stigma, independently increased depression severity (p < 0.001). Conversely, active coping strategies were protective, with lower depression scores observed among women employing adaptive coping mechanisms (p = 0.018). Other socio-demographic and clinical characteristics, including education, marital status, CD4 count and cancer stage, were not significantly associated with depression.
Conclusion: Depression is common among WLWH and CC in Tanzania, with older age, poor social support and negative self-image identified as significant risk factors, while active coping appeared protective. Integrating psychological screening, counseling and psychosocial interventions into routine oncologic and HIV care is critical to improve overall wellbeing and treatment outcomes in this vulnerable population.
