The associations between perceived family support, HIV-related stigma, and depression among PLHIV in South Africa: the moderating role of age

Purpose Depression remains a major mental health concern among people living with human immunodeficiency virus (PLHIV), with human immunodeficiency virus (HIV)-related stigma and family support identified as key psychosocial determinants. However, little is known about how these relationships vary across age groups. Therefore, this study aims to examine whether age moderates the effect of perceived family support and HIV-related stigma on depression among adult PLHIV. Design/methodology/approach A quantitative cross-sectional design was used among adult patients recruited through probability time–location sampling at a tertiary hospital between June and October 2020. Data were analyzed using IBM SPSS version 30 and the PROCESS macro. Descriptive statistics were computed to summarize the sample characteristics. Simple moderation analysis was estimated using two types of models, namely, a crude model and an adjusted model controlling for relevant covariates. Findings A total of 201 participants were included in the analysis, with ages ranging from 18 to 75 years (M = 39.28, SD = 12.12). In the unadjusted model, the interaction between perceived family support and middle-aged adults was statistically significant (B = 0.309, p = 0.021), but this association was attenuated after adjusting for gender, income, education, employment, and marital status (B = 0.256, p = 0.058). Adjusted conditional effects indicated that greater perceived family support was significantly associated with lower depression among young adults only (B = −0.352, p = 0.001). In contrast, the interaction between HIV-related stigma and middle-aged adults was significant even after controlling for sociodemographic factors (B = −0.274, p = 0.018). Adjusted conditional effects further showed that HIV-related stigma was significantly and positively associated with depression across all age groups, with the strongest association observed among young adults. Practical implications Findings inform and support HIV care practice that goes beyond uniform care approaches by providing empirical support for integrated HIV and mental health care models that are age-sensitive. Originality/value This study uniquely demonstrates that age differentially moderates the effects of perceived family support and HIV-related stigma on depression, revealing distinct psychosocial pathways across the adult life course of PLHIV.