Perspectives towards mental illness in people living with HIV/AIDS in South Africa

Abstract

Psychiatric disorders are more common in people living with HIV/AIDS (PLWHA) than in the general population and they exert a significant effect on many health-related outcomes. Low levels of mental health literacy and stigma may contribute to delayed treatment seeking and poorer outcomes. A convenience sample of 400 HIV-positive respondents were selected from three health clinics in Cape Town. Respondents' mental health literacy and attitudes towards psychiatric disorders were investigated. Psychiatric disorders were viewed as stress-related 70–91% of the time. Seeking help from a medical professional was often endorsed as an effective treatment option, while taking medication was rarely endorsed. Respondents held negative attitudes towards people with psychiatric disorders. In particular, people with substance abuse and PTSD were stigmatised more than those with depression and schizophrenia. The understanding of the psychobiological nature of psychiatric disorders and of existing effective treatments in PLWHA in South Africa is limited. Interventions designed to increase mental health literacy and reduce the stigma associated with psychiatric disorders may increase the likelihood of PLWHA seeking treatment should they suffer from these conditions.

Keywords:

• mental health
• health literacy
• stigma
• acquired immunodeficiency syndrome
• South Africa

Acknowledgements

This study was made possible by support from USAID/PEPFAR and the Peri-Natal Health Research Institute. The views expressed in this paper do not necessarily reflect those of USAID/PEPFAR. John A. Joska has received support from the National Research Foundation, the Biological Psychiatry special interest group of the South Africa Society of Psychiatrists, the Medical Research Council of South Africa and the Faculty of Health Sciences Research Committee, University of Cape Town. Dan J. Stein has received research grants and/or consultancy honoraria from Astrazeneca, Eli-Lilly, Glaxosmithkline, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo and Wyeth.

We would like to thank Ms. Anna Grimsrud for her statistical support.