Anxiety and Social Functioning among People Living with HIV/AIDS (PLWHA) in Pakistan: A Cross-Sectional Study

Background: Anxiety is a prevalent psychological comorbidity among people living with HIV/AIDS (PLWHA), contributing to impair social functioning and reduced quality of life. In resource-limited settings like Pakistan, stigma, discrimination, and inadequate mental health support further exacerbate these challenges. This study examines the impact of anxiety on social functioning in PLWHA compared to HIV-negative individuals and explores anxiety as a potential mediator in this relationship. Method: A cross-sectional design was employed, recruiting 200 participants (100 PLWHA, 100 HIV-negative) aged 20–50 years using convenience sampling. Demographic and clinical data, including CD4 count, disclosure status, HIV transmission category, and emotional disturbances, were collected through structured clinical interviews. Anxiety was assessed using the Institute for Personality and Ability Testing (IPAT) Anxiety Scale, and social functioning was measured using the Global Assessment of Functioning (GAF) Scale. Results: HIV-positive individuals exhibited significantly higher anxiety levels than their HIV-negative counterparts (p < .001), with women showing greater anxiety than men (p < .01). Mediation analysis revealed that anxiety significantly mediated the relationship between HIV status and social functioning, indicating that HIV-negative individuals had lower anxiety and better social functioning. Higher anxiety levels were associated with impaired social skills, fewer social interactions, and difficulties in interpersonal relationships. Conclusion: This study highlights the critical need for mental health interventions to enhance psychological well-being and social functioning among PLWHA. Addressing HIV-related stigma, strengthening social support networks, and integrating mental health care into HIV treatment programs are essential for improving outcomes. These findings underscore the importance of comprehensive, culturally tailored interventions, particularly in low- and middle-income countries like Pakistan, where stigma and limited mental health resources exacerbate social and psychological challenges.