Prevalence and Correlates of Psychological Distress Among HIV Positive Individuals in South Africa: Findings from the 2012 HIV National Household Survey

Authors

  • Nolusindiso Ncitakalo Medical Education Unit, Walter Sisulu University, Mthatha, South Africa
  • Musawenkosi Mabaso Social Aspects of Public Health Research Programme, Human Sciences Research Council, Durban, South Africa
  • Vincent Maduna Directorate of Research and Innovation, Tshwane University of Technology, Pretoria, South Africa
  • John Joska Department of Psychiatry & Mental Health, University of Cape Town, South Africa
  • Leickness Simbayi Human Sciences Research Council, Cape Town, South Africa & Honorary Professor, Department of Psychiatry & Mental Health, University of Cape Town, South Africa

DOI:

https://doi.org/10.12974/2313-1047.2019.06.6

Keywords:

Psychological distress, HIV positive individuals, HIV Prevalence, Correlates, Household survey, South Africa.

Abstract

Psychological distress symptoms like depression and anxiety are potentially dangerous conditions in HIV positive individuals influencing health-seeking behaviour, care and treatment leading to poor health outcomes. This study sought to determine the prevalence of psychological distress symptoms and associated socio-demographic and health-related factors amongst HIV positive individuals. The study used the 2012 data from a nationwide cross-sectional population-based household survey that was conducted using a multi-stage stratified cluster sampling design. Bivariate and multivariate logistic regression analysis were used to identify factors associated with psychological distress among HIV positive individuals. Of 2 536 HIV infected individuals found in the study, 34.5% reported psychological distress symptoms. The prevalence of reported psychological distress symptoms was significantly higher among females (38.2%) than males (28.5%). Increased likelihood of psychological distress among HIV positive males was significantly associated with residing in urban informal areas than urban formal areas [OR=2.5(95% CI: 1.2-5.6), p=0.021], not engaging in vigorous intensity sport [OR=2.1 (95% CI: 1.2-3.8), p=0.009]. The decreased likelihood was significantly associated with being employed [OR=0.6 (95% CI: 0.4-1.0), p=0.066], not having any chronic condition [OR=0.5(95% CI: (0.3-1.0), p=0.037], and low risk drinkers than hazardous drinkers [OR=0.3(95% CI: 0.1-0.9), p=0.036]. Among HIV positive females, increased likelihood of psychological distress was significantly associated with never seeing a health personnel [OR=2.8 (95% CI: 1.2-6.7), p=0.022]. The decreased likelihood was significantly associated with seeing a health personnel more than one year ago than in the past 6 months [OR=0.7 (95% CI: 0.4-1.0), p=0.051], and not having any chronic conditions [OR=0.6 (95% CI: 0.5-0.9), p=0.017]. The findings suggest a need for integrated interventions including those addressing mental health issues which target HIV positive individuals in urban informal areas, the unemployed, hazardous risk drinkers, and those with chronic medical conditions. 

References

UNAIDS. UNAIDS Data 2017. Geneva: UNAIDS, 2017

Simbayi LC, Zuma K, Zungu N, Moyo S, Marinda, Jooste S, Mabaso M, Ramlagan S, North A, van Zyl J, Mohlabane N, Dietrich C, Naidoo I, the SABSSMV Team. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017. Cape Town: HSRC Press, 2019.

Charles B, Jeyaseelan L, Pandian AK, Sam AE, Thenmozhi M, Jayaseelan V. Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India-a community based cross sectional study. BMC Public Health, 2012; 12: 463. https://doi.org/10.1186/1471-2458-12-463

Pappin M, Wouters E, Booysen F. Anxiety and depression amongst patients enrolled in a public sector antiretroviral treatment programme in South Africa: a cross-sectional study. BMC Public Health 2012; 12: 244. https://doi.org/10.1186/1471-2458-12-244

Brandt C, Zvolensky MJ, Woods SP, Gonzalez A, Safren SA, O'Cleirigh CM. Anxiety symptoms and disorders among adults living with HIV and AIDS: A critical review and integrative synthesis of the empirical literature. Clin Psychol Rev, 2017; 51: 164-184. https://doi.org/10.1016/j.cpr.2016.11.005

Nanni MG, Caruso R, Mitchell AJ, Meggiolaro E, Grassi L. Depression in HIV infected patients: a review. Curr Psychiatry Rep, 2015; 17(1): 530. https://doi.org/10.1007/s11920-014-0530-4

Kagee A, Saal W, De Villiers L, Sefatsa M, Bantjes J. The prevalence of common mental disorders among South Africans seeking HIV testing. AIDS Behav 2017; 21(6): 1511- 1517. https://doi.org/10.1007/s10461-016-1428-4

Tesfaye SH, Bune GT. Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia. Glob Health, 2014; 7. https://doi.org/10.3402/gha.v7.23882

Kagee A. Addressing psychosocial problems among persons living with HIV. Afr J Psychiatry, 2012; 15: 424-426. https://doi.org/10.4314/ajpsy.v15i6.53

Algoodkar S, Kidangazhiathmana A, Rejani PP, Shaji KS. Prevalence and Factors associated with Depression among Clinically Stable People Living with HIV/AIDS on Antiretroviral Therapy. Indian J Psychol Med, 2017; 39(6): 789-793. https://doi.org/10.4103/IJPSYM.IJPSYM_364_17

Kagotho N, Ssewamala FM. Correlates of depression among caregivers of children affected by HIV/AIDS in Uganda: findings from the Suubi-Maka family study. AIDS Care, 2012; 24(10): 1226-1232. https://doi.org/10.1080/09540121.2012.658754

Wang W, Xiao C, Yao X, Yang Y, Yan H, Li S. Psychosocial health and suicidal ideation among people living with HIV/AIDS: A cross-sectional study in Nanjing, China. PLoS ONE, 2018; 13(2): e0192940. https://doi.org/10.1371/journal.pone.0192940

Freeman M, Nkomo N, Kafaar Z, Kelly K. Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa. AIDS Care, 2007; 19(10): 1201- 1209. https://doi.org/10.1080/09540120701426482

Kagee A, Martin L. Symptoms of depression and anxiety among a sample of South African patients living with HIV. AIDS Care 2010; 22(2): 159-165. https://doi.org/10.1080/09540120903111445

Sorsdahl KR, Mall S, Stein DJ, Joska JA. Perspectives towards mental illness in people living with HIV/AIDS in South Africa. AIDS Care 2010; 22(11): 1418-1427. https://doi.org/10.1080/09540121003758655

Peltzer K, Shikwane ME. Prevalence of postnatal depression and associated factors among HIV-positive women in primary care in Nkangala district, South Africa. South Afr J HIV Med 2011; 12 (4), 24-28. https://doi.org/10.4102/sajhivmed.v12i4.168

Nyirenda M, Chatterji S, Rochat T, Mutevedzi P, Newell M-L. Prevalence and correlates of depression among HIV-infected and-affected older people in rural South Africa. J Affect Disord 2013; 151:31-8. https://doi.org/10.1016/j.jad.2013.05.005

Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D, et al. South African national HIV prevalence, incidence and behavior survey, 2012. Cape Town: HSRC Press; 2014.

Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med, 2002; 32(6): 959-976. https://doi.org/10.1017/S0033291702006074

Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E. Screening for serious mental illness in the general population. Arch Gen Psychiatry, 2003; 60(2): 184-189. https://doi.org/10.1001/archpsyc.60.2.184

Andrews G, Slade T. Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust N Z J Public Health. 2001; 25(6): 494-497. https://doi.org/10.1111/j.1467-842X.2001.tb00310.x

Spies G, Kader K, Kidd M, et al. Validity of the K-10 in detecting DSM-IV-defined depression and anxiety disorders among HIV-infected individuals. AIDS Care 2009; 21(9): 1163-1168. https://doi.org/10.1080/09540120902729965

Booysen F, van der Berg S, Burger R, von Maltitz M, du Rand G. Using an asset index to assess trends in poverty in seven sub-Saharan African countries. World Dev 2008; 36(6): 1113-1130. https://doi.org/10.1016/j.worlddev.2007.10.008

MCA - Multiple Correspondence Analysis in R: Essentials. Available on http://www.sthda.com/english/articles/31- principal-component-methods-in-r-practical-guide/114-mcamultiple- correspondence-analysis-in-r-essentials/. (Accessed on 10 December 2019).

Saunders JB, Aasland OG, Babor TF, de la Fuente JR Grant M. Development of the Alcohol Use Disorders Screening Test (AUDIT). WHO collaborative project on early detection of persons with harmful alcohol consumption. II. Addiction, 1993; 88, 791-804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x

Kalichman SC, Simbayi, LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science 2007; 8: 141-151. https://doi.org/10.1007/s11121-006-0061-2

Peltzer K, Davids A, Njuho P. Alcohol use and problem drinking in South Africa: Findings from a national populationbased survey. Afric J Psychiatry, 2011; 14(1): 30-37. https://doi.org/10.4314/ajpsy.v14i1.65466

Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A et al., SANHANES-1 Team. South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press, 2013.

Duko B, Toma A, Abraham Y. Prevalence and correlates of common mental disorder among HIV patients attending antiretroviral therapy clinics in Hawassa City, Ethiopia. Ann Gen Psychiatry 2019; 18:17. https://doi.org/10.1186/s12991-019-0241-7

Comulada WS, Rotheram-Borus MJ, Pequegnat W, Weiss RE, Desmond KA, Arnold EM, Chesney MA. Relationships over time between mental health symptoms and transmission risk among persons living with HIV. Psychol Addict Behav 2010; 24(1): 109-118. https://doi.org/10.1037/a0018190

Gibbs A, Govender K, Jewkes R. An exploratory analysis of factors associated with depression in a vulnerable group of young people living in informal settlements in South Africa, Global Public Health 2018; 13(7): 788-803. https://doi.org/10.1080/17441692.2016.1214281

Peltzer K, Pengpid S, Skaal L. Prevalence of psychological distress and associated factors in urban hospital outpatients in South Africa. SAJ Psychiatry 2012; 18(1): 10-15. https://doi.org/10.4102/sajpsychiatry.v18i1.304

Seth P, Kidder D, Pals S, Parent J, Mbatia R, Chesang K et al. Psychosocial Functioning and Depressive Symptoms Among HIV-Positive Persons Receiving Care and Treatment in Kenya, Namibia, and Tanzania. Prev Sci, 2014; 15(3); 318-328. https://doi.org/10.1007/s11121-013-0420-8

Biddle, S. Physical activity and mental health: evidence is growing. World Psychiatry 2016; 15(2): 176-177. https://doi.org/10.1002/wps.20331

Stubbs B, Vancampfort D, Smith L, Rosenbaum S, Schuch F, Firth J. Physical activity and mental health. Lancet Psychiatry, 2018; 5(11); 873. https://doi.org/10.1016/S2215-0366(18)30343-2

Bolton P, Bass J, Neugebauer R, Verdeli H, Clougherty KF, Wickramaratne P et al. Group interpersonal psychotherapy for depression in rural Uganda: a randomized controlled trial. JAMA, Style file-JPPR.doc 2003; 289(23): 3117-3124. https://doi.org/10.1001/jama.289.23.3117

Chibanda D, Weiss HA, Verhey R, Simms V, Munjoma R, Rusakaniko S et al. Effect of a Primary Care-Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe: A Randomized Clinical Trial. JAMA, 2016; 316(24): 2618-2626. https://doi.org/10.1001/jama.2016.19102

Downloads

Published

2019-03-08

How to Cite

Ncitakalo, N., Mabaso, M., Maduna, V., Joska, J., & Simbayi, L. (2019). Prevalence and Correlates of Psychological Distress Among HIV Positive Individuals in South Africa: Findings from the 2012 HIV National Household Survey. Journal of Psychology and Psychotherapy Research, 6, 30–40. https://doi.org/10.12974/2313-1047.2019.06.6

Issue

Section

Articles