Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Megan V. Smith


Nigeria has one of the largest global HIV burdens of disease. Structured Treatment Preparation (STP) is required of all newly diagnosed HIV+ individuals initiating Antiretroviral Therapy (ART) at AIDSReleif Local Partner Treatment Facilities (LPTFs), yet no information exists on whether STP has any effect on a patient's mental health. We believe that STP may be related to improvement in depression, anxiety, and stress scores of these individuals. A depression, anxiety, and stress measurement tool, (DASS) 21, was administered to patients from 6 randomly selected AIDSRelief LPTFs before and after the mandated 3-week STP preceding ART. Paired t-tests were used to compare pre- and post-intervention depression, anxiety, and stress scores of all participants. An analysis of variance was conducted to evaluate differences in score changes between LPTFs, and simple linear regressions were used to measure the correlations between age and (DASS) 21 score change and HIV knowledge and (DASS) 21 score change. We observed significant (DASS) 21 score changes for depression (p < 0.001), anxiety (p < 0.001), and stress (p < 0.001). Results remained significant when stratifying for gender. LPTFs DOC Kubwa [95% CIs: (3.42, 16.41), (2.50, 15.17), (2.22, 15.75)] and St. Gerard's Hospital [95% CIs: (3.28, 14.51), (2.59, 13.54), (3.81, 15.49)] demonstrated significantly greater degrees of change in depression, anxiety, and stress compared to St. Francis Jambutu. This study demonstrates that STP is associated with statistically significant changes in depression, anxiety, and stress scores of HIV + individuals initiating ART in Northern Nigeria.


This is an Open Access Thesis.