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

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 cross-sectional study in Epworth, Zimbabwe. Six subjects had indeterminate HIV-1 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 HIV 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% CI= 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.