HIV prevalence among men and women admitted to a South African public psychiatric hospital

Collins, Pamela Y.; Berkman, Alan; Mestry, Kezziah; Pillai, Aravind

doi:10.1080/09540120802626188

Cited by 44 publications

(42 citation statements)

References 11 publications

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“…In most previous studies from sub-Saharan Africa (but see [25]), no difference has been found in HIV prevalence between persons having different primary psychiatric disorders, i.e. schizophrenia, bipolar disorder, and depression [1-3,5], while several studies have reported high HIV prevalence in persons having ‘organic affective disorder’, ‘delirium’ [5], ‘psychotic disorder due to general medical condition’ [2] ‘and psychosis not otherwise specified’ [25], potentially due to inclusion of cases of SMI secondary to HIV into these categories. In the current study, we deemed the available chart diagnoses of HIV-associated mania/psychosis/depression unreliable, given the limited diagnostic modalities used at Butabika hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported HIV prevalence estimates below or similar to those in the general population [1-3], while others have reported estimates higher than those in background populations [4,5]. The reason for the variation in HIV prevalence across studies is unknown, but overall, might be due to sampling variability, context-specific selection processes (since studies were hospital-based), and differential survival of persons with SMI who are HIV infected.…”

Section: Introductionmentioning

confidence: 99%

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HIV prevalence in persons with severe mental illness in Uganda: a cross-sectional hospital-based study

Lundberg

Nakasujja

Musisi

et al. 2013

Int J Ment Health Syst

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BackgroundIn Uganda, a previous study reported high HIV prevalence in persons with severe mental illness (SMI) compared to the general population, suggesting that persons with SMI might constitute a high-risk group for HIV. However, the study included first-time psychiatric admissions only, a group whose HIV prevalence may not reflect the prevalence in persons with SMI in general. We determined prevalence and correlates of HIV in both first-time and previous psychiatric admissions, in a psychiatric hospital in Uganda.MethodsCross-sectional study of HIV status in persons consecutively discharged from psychiatric admission wards in Butabika hospital, Uganda. Inclusion criteria: age 18–49 years; schizophrenia, bipolar disorder, depression, or other non-substance-use-related psychosis; Luganda or English proficiency. Exclusion criterion: Mental incapacity to give informed consent. Participants were HIV-tested, and interviewed using a structured questionnaire. Data were analysed using logistic regression.ResultsHIV prevalence was 11.3% (CI 8.8-13.8) overall, 7.3% (CI 4.1-10.5) in men and 14.3% (CI 10.6-18.0) in women. Females had higher risk of HIV infection than males (OR 2.10; CI 1.20-3.67), after adjustment for age. Older patients had higher risk of HIV infection than younger patients (40–49 vs. 18–29 years: OR 2.34; CI 1.27-4.32), after adjustment for sex. Place of residence, marital status, income, education, occupation, psychiatric diagnosis and history of previous admission were not associated with HIV infection, after adjustment for sex and age. The above associations did not significantly differ between men and women.ConclusionsPersons admitted for SMI in Uganda have higher HIV prevalence than persons in the general population, irrespective of previous admissions. The excess HIV prevalence is mainly confined to women. The findings call for the integration of HIV prevention, testing and care with mental health services in settings with generalized HIV epidemics. Moreover, further research is needed to clarify the mechanisms underlying the increased HIV prevalence in women with SMI in Uganda, and to identify effective community-based interventions for this vulnerable group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HIV prevalence in persons with severe mental illness in Uganda: a cross-sectional hospital-based study

Lundberg

Nakasujja

Musisi

et al. 2013

Int J Ment Health Syst

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“…Childhood abuse, physical abuse, and especially sexual abuse have been found to be associated with unprotected sex and an increase in STI and HIV infection rates in several different populations: university students (19), among men who have sex with men (20), in people living with HIV (21), among individuals with a mental illness and/or substance abuse (22, 23, 24, 25) in African American women (26), urban American Indian women (27), women in substance abuse treatment (28), and women prisoners (29). …”

Section: Trauma and Hiv Risk Behaviorsmentioning

confidence: 99%

Trauma Exposure, PTSD, and HIV Sexual Risk Behaviors among Labor Migrants from Tajikistan

et al. 2012

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Little is known about the role of trauma and PTSD symptoms in the context of migration-associated HIV risk behaviors. A survey of Tajik married male seasonal labor migrants in Moscow was completed by 200 workers from 4 bazaars and 200 workers from 18 construction sites as part of a mixed method (quantitative and qualitative) study. The mean PC-PTSD score was 1.2 with one-quarter of migrants scoring at or above the cutoff of 3 indicating likely PTSD diagnosis. PC-PTSD score was directly correlated with both direct and indirect trauma exposure, but PC-PTSD score did not predict either HIV sexual risk behaviors or HIV protective behaviors. HIV sexual risk behavior was associated with higher indirect trauma exposure. PC-PTSD score was associated with some indicators of increased caution (e.g. more talking with partners about HIV and condoms; more use of condom when drinking). Qualitative findings were used to illustrate the differences between direct and indirect traumas in terms of HIV sexual risk. The study findings call for future efforts to address labor migrant's mental health needs and to integrate trauma dimensions into HIV prevention.

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“…Mental illness, in turn, can be a risk factor for contracting HIV infection [3]. Therefore, there is likely to be a considerable unmet need for HIV-care among people with mental illness, and for mental health care among HIV-infected persons [4].…”

Section: Introductionmentioning

confidence: 99%

A Descriptive Analysis of HIV Prevalence, HIV Service Uptake, and HIV-Related Risk Behaviour among Patients Attending a Mental Health Clinic in Rural Malawi

et al. 2013

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BackgroundHuman immunodeficiency virus (HIV) and mental illness are interlinked health problems; mental illness may pose a risk for contracting HIV and HIV-positive individuals are at higher risk of mental illness. However, in countries with high HIV prevalence, the main focus of HIV-related health programmes is usually on prevention and treatment of somatic complications of HIV, and mental illness is not given high priority. We examined HIV prevalence, uptake of HIV services, and HIV-related risk behaviour among people attending a mental health clinic in rural Malawi.MethodologySemi-structured interviews were performed with patients capable to consent (94%), and with those accompanied by a capable caregiver who consented. HIV counselling and testing was offered to participants.FindingsAmong 174 participants, we collected 162 HIV test results (91%). HIV prevalence was 14.8%. Women were three times as likely to be HIV-positive compared to men. Two-thirds of participants reported having been tested for HIV prior to this study. The uptake of HIV-services among HIV-positive patients was low: 35% did not use recommended prophylactic therapy and 44% of patients not receiving antiretroviral treatment (ART) had never been assessed for ART eligibility. The reported rate of sexual activity was 61%, and 9% of sexually active participants had multiple partners. Inconsistent condom use with stable (89%) and occasional (79%) sexual partners, and absence of knowledge of the HIV status of those partners (53%, 63%) indicate high levels of sexual risk behaviour.ConclusionsHIV-prevalence among persons attending the clinic, particularly men, was lower than among the general population in a population survey. The rate of HIV testing was high, but there was low uptake of preventive measures and ART. This illustrates that HIV-positive individuals with mental illness or epilepsy constitute a vulnerable population. HIV programmes should include those with neuropsychiatric illness.

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HIV prevalence among men and women admitted to a South African public psychiatric hospital

Abstract: In settings with low

Cited by 44 publications

References 11 publications

HIV prevalence in persons with severe mental illness in Uganda: a cross-sectional hospital-based study

HIV prevalence in persons with severe mental illness in Uganda: a cross-sectional hospital-based study

Trauma Exposure, PTSD, and HIV Sexual Risk Behaviors among Labor Migrants from Tajikistan

A Descriptive Analysis of HIV Prevalence, HIV Service Uptake, and HIV-Related Risk Behaviour among Patients Attending a Mental Health Clinic in Rural Malawi

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