<p><strong>Background.</strong> In order to gauge the impact of the HIV epidemic on psychotic disorders, the magnitude and causal direction of the association between HIV infection and psychosis need to be examined closely.</p><p><strong>Objective.</strong> To determine the HIV seropositivity rate among adult patients presenting with first-episode psychosis (FEP) to Town Hill Hospital in Pietermaritzburg, KwaZulu-Natal.</p><p><strong>Design.</strong> A cross-sectional, point-prevalence study was done over a 6-month period.</p><p><strong>Results.</strong> Of the 63 FEP patients in the study, 48 tested HIV- negative and 15 tested positive, giving a seroprevalence rate of 23.8%.</p><p><strong>Conclusion.</strong> The prevalence of HIV seropositivity is high among patients with FEP.</p>

Background. South Africa (SA) has a high prevalence rate of intimate partner violence (IPV) and HIV, both of which can be exacerbated further by HIV serodiscordancy in the couple dyad. Further exploration of the discordancy sidedness in known mediating factors, such as alcohol abuse risk and post-traumatic stress (PTS), is required. Objectives. To investigate the extent of and gender differences in IPV, alcohol abuse risk and PTS symptoms among HIV-serodiscordant couples in Durban, SA, and to analyse these further with regard to female HIV serostatus. Methods. A cross-sectional analysis of data on 30 serodiscordant couples was conducted at the point of enrolment into a pilot study of an HIV risk reduction intervention. The statistical procedure for a dependent small sample was applied to examine gender differences in IPV, alcohol use and PTS symptoms among HIV-serodiscordant couples. Results. The woman was HIV-positive in 18 (60.0%) of the 30 serodiscordant couples enrolled. Exposure to IPV differed significantly between men (28.6%) and women (89.3%) (proportional difference −0.61, 95% confidence interval (CI) −0.8–−0.39). The Wilcoxon signed-rank test showed that PTS symptom scores differed significantly between men (median 22, interquartile range (IQR) 23) and women (median 44, IQR 28) (p=0.03). When the above analysis was stratified by female HIV serostatus, significant gender differences were found in IPV and PTS in the couples where the woman was HIV-positive. There were no significant gender differences for alcohol abuse risk. Conclusions. The findings demonstrated high levels of IPV in HIV-serodiscordant couples and a significant gender difference in mental health risk such as PTS in such relationships, particularly where the woman was HIV-positive. HIV intervention programmes should address gender-based violence and inequity among heterosexual couples.

BackgroundSexual transmission of HIV frequently occurs in the context of a primary relationship between two partners; however, HIV prevention interventions generally focus on individuals at risk, rather than specifying couples as a unit of change and analysis, neglecting the crucial role that partners may play in sexual behaviour. This article reviews published scientific literature addressing couple-oriented HIV counselling and testing and other behavioural interventions using an online search for peer-reviewed papers.MethodsA systematic review was conducted to evaluate what has been published on psychosocial interventions in HIV serodiscordant couples in Africa. Electronic databases were searched from January 1990 to December 2015. Quality assessment of included studies was conducted using the Systematic Appraisal of Quality in Observational Research tool.ResultsThe electronic database searches initially retrieved 493 records; after cross-referencing, removing duplicates and applying strict inclusion and exclusion criteria, only eight papers were included in this review. All the studies under review showed that couples-focused counselling and educational programmes were associated with positive outcomes including reduced HIV transmission, reduced unprotected sex, increased rates of status disclosure and high levels of treatment adherence.ConclusionsThe literature on interventions for HIV serodiscordant couples is sparse. However, most interventions indicate that couples-focused interventions are effective in HIV risk reduction. In spite of the limited available data and repeated recommendations by different health authorities, couple-centred approaches to HIV prevention have not been implemented on a large scale.

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It is understandable that the challenges of living through a severe contagious outbreak, like the coronavirus disease 2019 (COVID-19), cannot be tolerated for long and that some individuals may require emotional, psychological, and spiritual support in order to strengthen their resilience to navigate this difficult period. As clinicians and researchers in the field of mental health, we need to appreciate the roles that culture, spirituality, and religion play in comforting people who survive such an outbreak and provide possible solutions for public health authorities on how to promote wellness. This appreciation should direct us to seek a deeper understanding of how culture, spirituality, and religion can be used to endure an outbreak of this magnitude and how the interruption of common practices can impact the coping skills of those who are affected. Our understanding of the roles that customs, beliefs, and values of South Africans play in building resilience will help inform and strengthen interventions that are aimed at controlling the spread of COVID-19.

Background: While untreated post-traumatic stress disorder (PTSD) results in considerable morbidity and higher risk of mortality, little has been done to treat PTSD in low resourced sub-Saharan Africa settings where there is mass exposure of the population to traumatic events. This systematic review aims to summarise available evidence on the efficacy of psychological therapies for PTSD in sub-Saharan Africa (SSA).Methods: A systematic search of literature in the PubMed, PsychInfo, EMBASE and Cochrane Register of Controlled Trials electronic databases will be conducted using keywords related to “PTSD”, “psychological therapies” and “SSA”. Two independent researchers will screen for studies eligible for inclusion if set in SSA and randomised controlled trial study design. Data on intervention types, population, comorbidities, comparison group intervention and PTSD outcomes will be extracted from included studies. Risk of bias will be assessed, qualitative synthesis of data will be conducted, and pooled effect estimates calculated.Discussion: Trauma in SSA occurs within the context of unique conditions necessitating applicable interventions. The results of the systematic review will be important in providing a guide for clinicians and researchers in low resource settings in development of effective interventions. Systematic review registration: PROSPERO (CRD42020181638)