Sustained Viral Suppression and its association with Psychiatric Morbidity and Sleep Quality among Older Adults with Human Immunodeficiency Virus: Evidence from a Retrospective Cohort in Ibadan, Nigeria.

Purpose Older adults with HIV are at risk of psychiatric disorders and poor sleep quality, but evidence from sub-Saharan Africa is limited, particularly regarding sustained viral suppression. This study examined the prevalence of psychiatric disorders and poor sleep quality symptoms and their association with sustained viral suppression among older adults with HIV in Nigeria. Methods: A retrospective cohort study was conducted among older adults receiving care at a tertiary HIV clinic in Ibadan, Nigeria. Viral load data from 2019-2023 were abstracted from medical records to determine sustained viral load suppression, while psychiatric morbidity and sleep quality were assessed cross-sectionally in 2023. Psychiatric assessments included major depressive disorder, anxiety disorder, bipolar disorder and mania. Mixed-effects logistic regression assessed changes in viral suppression over time and associations with psychiatric morbidity and sleep quality. Results: Among 400 participants, 63.5% were female and mean age was 58.2 years (S.D 6.5). A total of 25.8% had major depressive disorder, 17.5% had anxiety disorder, 29.3% had poor sleep quality, 3.3%, bipolar disorder, and 1.0% mania. Viral suppression improved significantly over the retrospective period. Sustained viral suppression was significantly associated with higher odds of good sleep quality (OR = 1.69, 95% CI: 1.07 to 2.66, p = 0.025), but not psychiatric morbidity. Conclusion: Psychiatric disorders and poor sleep quality are common among older adults with HIV in Nigeria. Sustained viral suppression was associated with better sleep quality but not psychiatric morbidity highlighting the importance of integrating mental health and sleep assessment into comprehensive HIV care for older adults.