Prevalence of HIV/AIDS and psychiatric disorders and their related risk factors among adults in Epworth, Zimbabwe

Abstract

Objectives: To examine the prevalence of HIV infection, neuropsychiatric disorders, psychiatric symptoms/signs, alcohol use/misuse, CD4 cell counts and risk factors in adult patients. Design: Cross-sectional study. Setting: Epworth, which is about 15km on the southeastern part of Harare, Zimbabwe. Subjects: Two hundred subjects were included in the study out of which six were excluded beacause of HIV-1 indeterminate results. Materials and Methods: A convenience sample of 200 subjects recruited in a crosssectional study in Epworth, Zimbabwe. Six subjects had indeterminate HIV-I antibody results and were excluded from the study. The remaining 194 subjects of whom 101 (52.1%) knew about their sero-status and were consecutively recruited, whereas, 93 (47.9%) did not know about their sero-status and were recruited by a systematic random sampling method (1-in-3). They were then interviewed about neuropsychiatric disorders using BPRS, MADRS, AUDIT and MINI Mental State Test, including the risk factors related to HIV infection. After ELISA tests' results, the two groups were combined and then categorised into HIV positive (n=115) and HlV negative (n=79) subjects. Main outcome measures: Prevalence, neuropsychiatric disorders, increased CD4 cell counts and risk factors associated with HIV infection.Results: The findings were that the overall point prevalence of the HIV infection was 59.3% (115/194). Comparative analyses between seropositive and seronegative HIV/AIDS subjects showed: over two thirds (71.3%) of the HIV positive subjects suffered from psychiatric disorders, more than those with HIV negative 44.3% (OR= 3.12, 95% Cl= 1.64-5.95, P=0.0002), and subjects aged 35 years and less were mostly HIV seronegatives (n= 77.2%, OR= 2.34, 95% CI= 1.18-4.75, P=0.014). The overall prevalence of alcohol use/misuse was 41(21.1%), with higher prevalence rate among HIV positive subjects, 28 (24.3%) than those who were HIV negative, 13 (16.5%). The commonest psychiatric symptoms/signs (P<0.05) were emotional withdrawal, depressed mood, suspiciousness, apparent sadness, reduced sleep and suicidal thoughts (specially among women). Conclusion: There is very high point prevalence of HIV/AIDS and psychiatric disorders, including a moderate prevalence rate of alcohol use/misuse in this less affluent community that warranted intervention.

Descriptive systematic review of sub-Saharan African studies on the association between alcohol use and HIV infection

“…An unmatched case control study among men and women visiting HIV testing and counselling centres found that persons who had used alcohol at some stage in their life were significantly more likely to be HIV+ than those who had never used alcohol (Seme et al, 2005) Two of the community/population-based studies involving both men and women that used an ever use/never use dichotomy (last month or lifetime use) found that persons who had used alcohol were significantly more likely to be HIV+ than persons who had not used alcohol over the specified time period (Hargreaves et al, 2002;Mbulaiteye et al, 2000). These findings conflict with those of another study that found no significant difference between current users and non-users of alcohol with regards to HIV prevalence (Sebit et al, 2003). The last study in this group found that the consumption of local brew or bottled alcohol at least once per week was significantly associated with HIV-1 infection among men, but not among women (Mmbaga et al, 2007).…”

“…A cross-sectional study was conducted in Epworth, Zimbabwe, to determine the overall prevalence of HIV and psychiatric disorders and their related risk factors among 194 adults in this less affluent community (Sebit et al, 2003). Two sample populations and two sampling methods for subject recruitment were used.…”

Alcohol Use, Depressive Symptoms and the Receipt of Antiretroviral Therapy in Southwest Uganda

“…Across Africa, however, reports of alcohol use among HIV positive persons show variable rates. Sebit et al observed a prevalence of alcohol use/misuse among HIV positive adult outpatients in Zimbabwe of 24.3% (Sebit et al 2003), while Shaffer et al recorded 54% of both HIV positive and negative public clinic patients in Kenya as hazardous drinkers according to the AUDIT (Shaffer et al 2004). Past alcohol use was more common than current use suggesting that participants may have decreased their level of alcohol consumption concurrent with entering medical care.…”

An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

“…Of the 20 studies included in Fisher and colleagues' meta-analysis, 19 were retained for inclusion in the present study (Ao, Sam, Masenga, Seage, & Kapiga, 2006;Ayisi et al, 2000;Braddick et al, 1990;Demissie, Amre, & Tsega, 1996;Fritz et al, 2002;Hargreaves et al, 2002;Kapiga, Lyamuya, Lwihula, & Hunter, 1998;Kapiga et al, 2002;Kapiga et al, 2006;Lewis et al, 2005;Mbulaiteye et al, 2000;Mnyika, Klepp, Kvåle, & Ole-King'ori, 1996;Ndina-Achola et al, 1997;Sebit et al, 2003;Simbayi et al, 2004;Talbot et al, 2002;Tengia-Kessey, Msamanga, & Moshino, 1998;Zablotska et al, 2006;Zuma, Gouws, Williams, & Lurie, 2003) and one (Gilgen, Williams, & Campbell, 2000) was excluded for failing to meet the inclusion criteria specified below (i.e., it was not published in a peer-reviewed journal). An additional eight nonoverlapping studies published prior to 2009 were identified from our previous narrative review (Allen et al, 1992;Bassett et al, 1996;Clift et al, 2003;Dunkle et al, 2004;Fisher, Cook, Sam, & Kapiga, 2008;Msuya et al, 2006;St.…”