Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe

• DOI: 10.1007/s10461-017-1705-x
• Publication Date: 2017-02-13T11:31:50Z
• Authors: Malebogo Tlhajoane; Jeffrey W. Eaton; Albert Takaruza; Rebecca Rhead; Rufurwokuda Maswera; Nadine Schur; Lorraine Sherr; Constance Nyamukapa; Simon Gregson
• Keywords: Adult; Male; Zimbabwe; Treatment cascade; Social Psychology; Adolescent; Anti-HIV Agents; Sexual Behavior; 610; HIV Infections; Medication Adherence; Young Adult; 03 medical and health sciences; Risk-Taking; 0302 clinical medicine; Surveys and Questionnaires; Prevalence; Humans; Original Paper; Public Health, Environmental and Occupational Health; 1. No poverty; Social Support; Middle Aged; Patient Acceptance of Health Care; Antiretroviral therapy; 3. Good health; Infectious Diseases; Cross-Sectional Studies; 1117 Public Health And Health Services; Adherence; HIV/AIDS; Mental health; Female; Public Health; Stress, Psychological

The correlation between mental health and sexual risk behaviours for HIV infection remains largely unknown in low and middle income settings. The present study determined the prevalence of psychological distress (PD) in a sub-Saharan African population with a generalized HIV epidemic, and investigated associations with HIV acquisition risk and uptake of HIV services using data from a cross-sectional survey of 13,252 adults. PD was measured using the Shona Symptom Questionnaire. Logistic regression was used to measure associations between PD and hypothesized covariates. The prevalence of PD was 4.5% (95% CI 3.9-5.1%) among men, and 12.9% (95% CI 12.2-13.6%) among women. PD was associated with sexual risk behaviours for HIV infection and HIV-infected individuals were more likely to suffer from PD. Amongst those initiated on anti-retroviral therapy, individuals with PD were less likely to adhere to treatment (91 vs. 96%; age- and site-type-adjusted odds ratio = 0.38; 95% CI 0.15, 0.99). Integrated HIV and mental health services may enhance HIV care and treatment outcomes in high HIV-prevalence populations in sub-Saharan Africa.