Spiritual and religious aspects influence mental health and viral load: A quantitative study among young people living with HIV in Zimbabwe

Wüthrich-Grossenbacher, Ursula; Mutsinze, Abigail; Wolf, Ursula; Maponga, Charles Chiedza; Midzi, Nicholas; Mutsaka-Makuvaza, Masceline; Merten, Sonja (26 April 2023). Spiritual and religious aspects influence mental health and viral load: A quantitative study among young people living with HIV in Zimbabwe (medRxiv). Cold Spring Harbor Laboratory 10.1101/2023.04.24.23289049

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Introduction: The role of religion and spirituality as social determinants of health have been widely
discussed in and outside the World Health Organization. Studies among people living with Human
Immunodeficiency Virus (HIV) describe positive and negative influences of religion and spirituality on
health outcome. With a HIV prevalence of 14.8% for females and 8.6% for males, and 22’000 Aids
related deaths in 2020, HIV infection remains a life-threatening condition in Zimbabwe, especially for
young people. The aim of this research was to measure the influence of religion and spirituality on
the health outcome of young people living with HIV in Zimbabwe.
Methods: A quantitative questionnaire with three different validated measures of religion and
spirituality (Belief in Action Scale, Brief Religious Coping Index, Religious and Spiritual Struggles
Scale), demographic, cultural, behavioral, and health questions was administered to 804 young
Zvandiri program clients in rural, urban, and peri-urban Zimbabwe between July and October 2021.
Regression analysis established significant relations between the result of the three different
measures and mental health and viral load results.
Results: Religious coping significantly reduced the probability of common mental disorder, while high
religious activity increased the risk. The Religious and Spiritual Struggles scale proved to be a reliable
indicator of higher viral loads, risk for treatment failure, and the probability of common mental
disorder.
Conclusions: The Religious and Spiritual Struggles scale should be used and validated in other subSaharan contexts. It could serve as a new diagnostic tool for the early detection and prevention of
treatment failure as well as of common mental disorder.

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