Eugene Kinyanda1, Noeline Nakasujja2, Jonathan Levin3, Harriet Birabwa4, Richard Mpango5, Heiner Grosskurth6, Soraya Seedat7, Vikram Patel8. 1. Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS/ MRC-DFID African Leadership Award, Entebbe, Uganda; Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: Eugene.Kinyanda@mrcuganda.org. 2. Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda. Electronic address: drnoeline@yahoo.com. 3. Statistical Section, MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: Jonathan.Levin@mrcuganda.org. 4. Butabika National Psychiatric Referral Hospital, Kampala, Uganda. Electronic address: htbrabwa@yahoo.com. 5. Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS/ MRC-DFID African Leadership Award, Entebbe, Uganda. 6. London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: Heiner.Grosskurth@lshtm.ac.uk. 7. Stellenbousch University, Cape Town, South Africa. Electronic address: SSEEDAT@sun.ac.za. 8. London School of Hygiene and Tropical Medicine, London, United Kingdom; Senior Wellcome Trust Fellowship, London, United Kingdom. Electronic address: vikram.patel@lshtm.ac.uk.
Abstract
INTRODUCTION: There is a paucity of research into the psychiatric problems associated with early stage HIV clinical disease in sub-Saharan Africa. METHODS: A cross sectional study was undertaken among 899 adult ART naïve persons in early stage HIV clinical disease (participants with CD4≥250 and who were at WHO clinical Stage I or II) attending a semi-urban and a rural clinic in Uganda. RESULTS: The prevalence of major depressive disorder in this study was 14.0% [95% CI 11.7-6.3%] while that of 'moderate to high risk for suicidality' was 2.8% [95% CI 1.7%; 3.9%]. Multivariable analyses found that factors in the socio-demographic, vulnerability/protective and stress (only for major depressive disorder) domains were significantly associated with both major depressive disorder and 'moderate to high risk for suicidality'. Major depressive disorder but not 'moderate to high risk for suicidality' was significantly associated with impaired psychosocial functioning, greater utilisation of health services and non-adherence to septrin/dasone. Neither major depressive disorder nor 'moderate to high risk for suicidality' was associated with CD4 counts, risky sexual behaviour nor with non-utilisation of condoms. LIMITATIONS: The bidirectional nature of some of the relationships between the investigated psychiatric problems, risk factors and outcomes in this cross sectional study makes it difficult to elucidate the actual direction of causality. CONCLUSION: Early stage HIV clinical disease is associated with considerable major depressive disorder and 'moderate to high risk for suicidality'. Therefore there is a need to integrate mental health into HIV interventions that target early stage HIV disease.
INTRODUCTION: There is a paucity of research into the psychiatric problems associated with early stage HIV clinical disease in sub-Saharan Africa. METHODS: A cross sectional study was undertaken among 899 adult ART naïve persons in early stage HIV clinical disease (participants with CD4≥250 and who were at WHO clinical Stage I or II) attending a semi-urban and a rural clinic in Uganda. RESULTS: The prevalence of major depressive disorder in this study was 14.0% [95% CI 11.7-6.3%] while that of 'moderate to high risk for suicidality' was 2.8% [95% CI 1.7%; 3.9%]. Multivariable analyses found that factors in the socio-demographic, vulnerability/protective and stress (only for major depressive disorder) domains were significantly associated with both major depressive disorder and 'moderate to high risk for suicidality'. Major depressive disorder but not 'moderate to high risk for suicidality' was significantly associated with impaired psychosocial functioning, greater utilisation of health services and non-adherence to septrin/dasone. Neither major depressive disorder nor 'moderate to high risk for suicidality' was associated with CD4 counts, risky sexual behaviour nor with non-utilisation of condoms. LIMITATIONS: The bidirectional nature of some of the relationships between the investigated psychiatric problems, risk factors and outcomes in this cross sectional study makes it difficult to elucidate the actual direction of causality. CONCLUSION: Early stage HIV clinical disease is associated with considerable major depressive disorder and 'moderate to high risk for suicidality'. Therefore there is a need to integrate mental health into HIV interventions that target early stage HIV disease.
Authors: Jennifer Velloza; Connie Celum; Jessica E Haberer; Kenneth Ngure; Elizabeth Irungu; Nelly Mugo; Jared M Baeten; Renee Heffron Journal: AIDS Behav Date: 2017-08
Authors: Mark Mohan Kaggwa; Sarah Maria Najjuka; Felix Bongomin; Mohammed A Mamun; Mark D Griffiths Journal: PLoS One Date: 2022-10-20 Impact factor: 3.752
Authors: Eugene Kinyanda; Leticia Kyohangirwe; Richard S Mpango; Christine Tusiime; Joshua Ssebunnya; Kenneth Katumba; Patrick Tenywa; James Mugisha; Geoffrey Taasi; Hafsa Sentongo; Dickens Akena; Yoko Laurence; Wilson Muhwezi; Helen A Weiss; Melissa Neuman; Giulia Greco; Birthe Knizek; Jonathan Levin; Pontiano Kaleebu; Ricardo Araya; Wilber Ssembajjwe; Vikram Patel Journal: Int J Ment Health Syst Date: 2021-05-12
Authors: Allan Kalungi; Soraya Seedat; Sian M J Hemmings; Lize van der Merwe; Moses L Joloba; Ann Nanteza; Noeline Nakassujja; Harriet Birabwa; Jennifer Serwanga; Pontiano Kaleebu; Eugene Kinyanda Journal: BMC Genet Date: 2017-07-25 Impact factor: 2.797