Real-World Outcomes, Safety and Determinants of Psychotropic Medication Use Among People Living With Hiv/AIds in the Niger Delta, Nigeria: A Cross-Sectional Analysis

Background. Antidepressants and antipsychotics can improve outcomes for people living with HIV/AIDS (PLWHA), but real-world evidence on their effectiveness, safety, cost and quality-of-life impact—and on the factors that drive their use—is limited in low- and middle-income countries. Objective. To evaluate the perceived outcomes, safety and quality-of-life impact of psychotropic medication among PLWHA in Bayelsa State, Nigeria, and to identify determinants of their use. Methods. A cross-sectional study of 336 PLWHA at the Federal Medical Centre, Yenagoa, included 77 psychotropic users analysed in detail. Associations between psychotropic use and outcomes were tested with chi-square; an independent-samples t-test compared the antidepressant (fluoxetine) and antipsychotic (haloperidol–olanzapine) groups; and multiple linear regression assessed the joint contribution of socio-demographic variables. Significance was set at 0.05. Results. Most antidepressant users rated their therapy very effective (58.4%), very safe (71.4%) and very positive for quality of life (62.3%); associations with effectiveness, safety, cost and quality of life were all statistically significant (p < 0.001). The two drug groups differed significantly on the measured outcome (t = –6.873, p < 0.001). Socio-demographic variables jointly explained only 6.8% of the variance in psychotropic use and were not significant predictors (F = 0.543, p > 0.05). Conclusion. Psychotropic therapy was associated with favourable self-reported outcomes, and the differences between drug groups reflected distinct clinical indications rather than relative superiority. Socio-demographic factors were weak predictors of use, pointing to clinical need and health-system factors as the principal drivers.