International literature, most of which originates from First-world countries where HIV
predominantly affects socially marginalised minority populations, has well-described the
burden of mental disorder, particularly depressive and anxiety disorders in HIV-infected
individuals. The few studies conducted in developing countries show contradictory results.
This study aimed to describe the occurrence of mental disorders; particularly depressive
and anxiety disorders, in a population of HIV-infected individuals attending HIV-treatment
sites in Gauteng and Mpumalanga in South Africa from November 2004 to November
2005.
A cross-sectional descriptive-analytic study, it included a clinical diagnostic interview and
a semi-structured interview to explore postulated risk and protective factors, including
demographic, clinical and psychosocial variables, for depressive and anxiety disorders in
HIV-infected individuals. Three hundred and two (302) individuals were interviewed at the
Perinatal HIV Research Unit’s associated Wellness clinics and at the Chris Hani
Baragwanath Hospital’s Nthabiseng HIV clinic.
Just over thirty percent of participants had a current mental disorder and the lifetime
prevalence of mental disorder was 40%. Almost 17% of participants had a current
depressive disorder and almost 16% had a lifetime depressive disorder. The occurrence of
major depressive disorder, current and lifetime, was 3.64% and 10.26% respectively. Sixty
percent of participants with lifetime major depressive disorder had their first onset after
diagnosis of HIV status. The occurrence of current and lifetime anxiety disorder was
almost 4%.
Substance use disorders were common, affecting 7.6% of the participants at time of
interview. Lifetime prevalence of substance use disorders was 18.9%, suggesting that
knowledge of HIV status or other interventions may have resulted in this significant
decrease.
Identified significant risk factors for depressive disorder included a history of a lifetime
depressive disorder, moderate or severe psychosocial stress and feelings of isolation. Being
in a support group was found to be a protective factor against depressive disorder.
While the results in this study are conservative compared to those of other similar South
African studies in HIV-infected individuals, there was a statistically significantly increased
occurrence of depressive and anxiety disorders (combined) compared to general population
prevalence studies of these disorders in South Africa. Ways of improving access to mental
healthcare for HIV-infected individuals and the general population, are discussed
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/6939 |
| Date | 08 May 2009 |
| Contributors | Thom, Rita |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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