Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa

Abstract

The study examines the association between the presence of mental disorder and a range of independent variables. A sample of 900 HIV-positive individuals was administered the Composite International Diagnostic Interview to determine the presence of selected mental disorders. A structured interview assessed support received and factors that may contribute to mental disorder. Overall prevalence of mental disorder was 43.7%—though higher in Stage 3 (49.7%) and in Stage 4 (68%) of the disease. Eighteen percent of respondents were receiving antiretroviral treatment. Having had pre- and post-test counselling was not related to mental disorder; nor were the number of sessions, the professional status of the counsellor and perceived helpfulness of counselling. Being in an HIV support group was related to presence of a mental disorder, although the frequency of attendance was not. Although most of those who disclosed their HIV status found the experience helpful there was a significant positive association between presence of a mental disorder and having disclosed HIV-positive status. Although being a member of an association for people with HIV/AIDS and being religious was perceived as helpful, neither was statistically associated with the presence of mental disorder. Discrimination by community and family and isolation were related to mental disorder. Death of a significant other due to AIDS was related to mental disorder. The findings suggest a strong need for provision of psychiatric care as part of AIDS care as well as strengthening of support services.

Acknowledgements

We wish to thank Professors Mkize and Seedat for conducting the CIDI training and Sharon Kleintjes for assisting with additional training. We also wish to thank the research co-ordinators and the interviewers in the four provinces. Finally we thank the participants in the study for openly sharing their sometimes highly emotional experiences.