Magnitude of Depression and Associated Factors in Women Living With HIV in Northwest, Ethiopia: Mediation Analysis

<b>Background:</b> Depression in women living with HIV (WLWHIV), is one of the most common public health concerns worldwide. Depression has a negative impact on antiretroviral therapy (ART) adherence, quality of life, poor HIV treatment outcomes, and mortality. However, there is a paucity of evidence in low-income countries such as Ethiopia in WLWHIV. <b>Objective:</b> The aim of this study is to assess the magnitude of depression and related factors, and how social support mediates HIV-related stigma and depression in WLWHIV. <b>Method:</b> A cross-sectional study was conducted among 1043 patients in a health institution, employing a systematic random sampling technique to select the study participants. The structured Patient Health Questionnaire (PHQ-9), Oslo Social Support Scale, Perceived HIV-related stigma scale, Household Food Insecurity Access Scale (HFIAS), and Violence Against Women Scale were used to measure depression, social support, stigma, food insecurity, and intimate partner violence, respectively. Descriptive statistics were computed, and multivariate logistic regression and mediation analyses were conducted to identify factors associated with depression and how they mediate it. <b>Results:</b> The prevalence of depression among WLWHIV was 41.7% (95% CI: 38.7% and 44.5%). Being single (AOR = 1.80, 95% CI: 1.09-2.99), divorced (AOR = 1.56, 95% CI: 1.11-2.19), widowed (AOR = 1.93, 95% CI: 1.31-2.84), experiencing medical illness comorbidity (AOR = 2.74, 95% CI: 1.75-4.30), having a high viral load (AOR = 1.86, 95% CI: 1.00-3.45), receiving social support (AOR = 0.90, 95% CI: 0.84-0.96), experiencing perceived HIV-related stigma (AOR = 1.04, 95% CI: 1.02-1.06), experiencing food insecurity (AOR = 1.07, 95% CI: 1.03-1.11), and experiencing psychological violence (AOR = 2.05, 95% CI: 1.30-3.23) were significantly associated with depression. Social support partially mediated the relationship between perceived HIV-related stigma and depression. <b>Conclusion:</b> More than two of five WLWHIV developed depression. Depression is indirectly affected by perceived HIV-related stigma through social support. Social support enhances mental health well-being.