Non-Adherence and First Line Antiretroviral Therapy failure among people living with HIV on Antiretroviral Therapy in Bulawayo city, 2016.

Schizophrenia is a severe mental disorder that often leads to substantial functional impairment () and disease burden (). The pathophysiology of schizophrenia is widely considered to involve a complex interactions between genetic and environmental factors (). Among the environmental influences, psychosocial stress has consistently been identified as a critical risk factor for both the onset and chronic course of schizophrenia (, ). Accumulating evidence suggests that exposure to stress can lead to dysregulated dopaminergic neurotransmission (, ), providing a neurobiological link between stress and psychotic symptoms. Perceived stress reflects how stressors are appraised and experienced by individuals. Previous studies have associated elevated perceived stress with psychosis-like experiences, which are subthreshold phenomena that may precede the onset of schizophrenia (, ). Moreover, perceived stress has been shown to mediate the relationship between social functioning and quality of life in individuals at ultra-high risk for psychosis (). In patients with first-episode schizophrenia, higher levels of perceived stress have also been consistently associated with depression (, ), and suicidality (). Stress dysregulation involves key brain regions of the corticolimbic system (). Neuroimaging studies have reported modest associations between perceived stress and gray matter volumes of the hippocampus and amygdala (both ’s < 0.3) (). As a primary target of stress hormones (, ), the hippocampal circuitry is central to stress-related structural and functional brain plasticity (). Importantly, hippocampal neurogenesis plays a key role in shaping individual stress experiences and coping responses ().