A descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi

dc.contributor.authorLommerse, Kinkeen_ZA
dc.contributor.authorStewart, Robert Cen_ZA
dc.contributor.authorChilimba, Queenen_ZA
dc.contributor.authorAkker, Thomas van denen_ZA
dc.contributor.authorLund, Cricken_ZA
dc.date.accessioned2015-11-16T04:07:17Z
dc.date.available2015-11-16T04:07:17Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: Human immunodeficiency virus (HIV) and mental illness are interlinked health problems; mental illness may pose a risk for contracting HIV and HIV-positive individuals are at higher risk of mental illness. However, in countries with high HIV prevalence, the main focus of HIV-related health programmes is usually on prevention and treatment of somatic complications of HIV, and mental illness is not given high priority. We examined HIV prevalence, uptake of HIV services, and HIV-related risk behaviour among people attending a mental health clinic in rural Malawi. METHODOLOGY: Semi-structured interviews were performed with patients capable to consent (94%), and with those accompanied by a capable caregiver who consented. HIV counselling and testing was offered to participants. FINDINGS: Among 174 participants, we collected 162 HIV test results (91%). HIV prevalence was 14.8%. Women were three times as likely to be HIV-positive compared to men. Two-thirds of participants reported having been tested for HIV prior to this study. The uptake of HIV-services among HIV-positive patients was low: 35% did not use recommended prophylactic therapy and 44% of patients not receiving antiretroviral treatment (ART) had never been assessed for ART eligibility. The reported rate of sexual activity was 61%, and 9% of sexually active participants had multiple partners. Inconsistent condom use with stable (89%) and occasional (79%) sexual partners, and absence of knowledge of the HIV status of those partners (53%, 63%) indicate high levels of sexual risk behaviour. CONCLUSIONS: HIV-prevalence among persons attending the clinic, particularly men, was lower than among the general population in a population survey. The rate of HIV testing was high, but there was low uptake of preventive measures and ART. This illustrates that HIV-positive individuals with mental illness or epilepsy constitute a vulnerable population. HIV programmes should include those with neuropsychiatric illness.en_ZA
dc.identifier.apacitationLommerse, K., Stewart, R. C., Chilimba, Q., Akker, T. v. d., & Lund, C. (2013). A descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi. <i>PLoS One</i>, http://hdl.handle.net/11427/14978en_ZA
dc.identifier.chicagocitationLommerse, Kinke, Robert C Stewart, Queen Chilimba, Thomas van den Akker, and Crick Lund "A descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/14978en_ZA
dc.identifier.citationLommerse, K., Stewart, R. C., Chilimba, Q., van den Akker, T., & Lund, C. (2014). A descriptive analysis of HIV prevalence HIV service uptake and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi. PloS One, 8(8), e72171. doi:10.1371/journal.pone.0072171en_ZA
dc.identifier.ris TY - Journal Article AU - Lommerse, Kinke AU - Stewart, Robert C AU - Chilimba, Queen AU - Akker, Thomas van den AU - Lund, Crick AB - BACKGROUND: Human immunodeficiency virus (HIV) and mental illness are interlinked health problems; mental illness may pose a risk for contracting HIV and HIV-positive individuals are at higher risk of mental illness. However, in countries with high HIV prevalence, the main focus of HIV-related health programmes is usually on prevention and treatment of somatic complications of HIV, and mental illness is not given high priority. We examined HIV prevalence, uptake of HIV services, and HIV-related risk behaviour among people attending a mental health clinic in rural Malawi. METHODOLOGY: Semi-structured interviews were performed with patients capable to consent (94%), and with those accompanied by a capable caregiver who consented. HIV counselling and testing was offered to participants. FINDINGS: Among 174 participants, we collected 162 HIV test results (91%). HIV prevalence was 14.8%. Women were three times as likely to be HIV-positive compared to men. Two-thirds of participants reported having been tested for HIV prior to this study. The uptake of HIV-services among HIV-positive patients was low: 35% did not use recommended prophylactic therapy and 44% of patients not receiving antiretroviral treatment (ART) had never been assessed for ART eligibility. The reported rate of sexual activity was 61%, and 9% of sexually active participants had multiple partners. Inconsistent condom use with stable (89%) and occasional (79%) sexual partners, and absence of knowledge of the HIV status of those partners (53%, 63%) indicate high levels of sexual risk behaviour. CONCLUSIONS: HIV-prevalence among persons attending the clinic, particularly men, was lower than among the general population in a population survey. The rate of HIV testing was high, but there was low uptake of preventive measures and ART. This illustrates that HIV-positive individuals with mental illness or epilepsy constitute a vulnerable population. HIV programmes should include those with neuropsychiatric illness. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0072171 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - A descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi TI - A descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi UR - http://hdl.handle.net/11427/14978 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14978
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0072171
dc.identifier.vancouvercitationLommerse K, Stewart RC, Chilimba Q, Akker Tvd, Lund C. A descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawi. PLoS One. 2013; http://hdl.handle.net/11427/14978.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Lommerse et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherMental health and psychiatryen_ZA
dc.subject.otherEpilepsyen_ZA
dc.subject.otherHIV clinical manifestationsen_ZA
dc.subject.otherMalawien_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherHIV preventionen_ZA
dc.titleA descriptive analysis of HIV prevalence, HIV service uptake, and HIV-related risk behaviour among patients attending a mental health clinic in Rural Malawien_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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