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Xiong P, Chen Y, Shi Y, Liu M, Yang W, Liang B, Liu Y. Global burden of diseases attributable to intimate partner violence: findings from the Global Burden of Disease Study 2019. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02637-x. [PMID: 38520514 DOI: 10.1007/s00127-024-02637-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Our study aims to evaluate the global burden of disease attributable to IPV from 1990 to 2019 at global, regional, national, and socio-demographic index (SDI) levels. Our research question is: What is the global burden of disease attributable to intimate partner violence (IPV) from 1990 to 2019, and how does it vary at global, regional, national, and socio-demographic index (SDI) levels? METHODS Data parameters for the number of deaths, disability-adjusted life years (DALYs), and age-standardized rate were obtained from the Global Burden of Disease Study 2019. We calculated the percentage change and population attributable fraction with 95% uncertainty intervals. RESULTS IPV directly accounted for 0.14% [95% UI 0.09%, 0.21%] and 0.32% [95% UI 0.17%, 0.49%] of global all-cause deaths and DALYs in 2019, respectively. The age-standardized deaths and DALYs rates of IPV increased by 12.83% and 4.00% respectively from 1990 to 2019. Women aged 35-39 and 30-34 had the highest deaths and DALYs rate respectively. The highest age-standardized rates of IPV-related deaths and DALYs were observed in Southern Sub-Saharan. Both of deaths and DALYs were high in low-socio-demographic Index (SDI) quintile in 2019. CONCLUSIONS A higher level of deaths and DALYs attributable to IPV were reported in younger women, in the early 2000s, in Southern Sub-Saharan regions and in low SDI regions. Our study provides policymakers with up-to-date and comprehensive information.
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Affiliation(s)
- Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China.
| | - Yuhan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Yuchen Shi
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
- Capital University of Economics and Business, Beijing, People's Republic of China
| | - Min Liu
- Zhuhai Center for Maternal and Child Health Care, Zhuhai, People's Republic of China
| | - Weixin Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
- Department of Dermato-Venereology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Baolin Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, 510632, People's Republic of China
| | - Yaozhong Liu
- Guangzhou Huashang College, Guangzhou, People's Republic of China
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Tsai YT, K. M. SP, Ku HC, Wu YL, Ko NY. Global overview of suicidal behavior and associated risk factors among people living with human immunodeficiency virus: A scoping review. PLoS One 2023; 18:e0269489. [PMID: 36940193 PMCID: PMC10029973 DOI: 10.1371/journal.pone.0269489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 05/22/2022] [Indexed: 03/21/2023] Open
Abstract
Death by suicide is a major public health problem. People living with human immunodeficiency virus (PLHIV) have higher risk of suicidal behavior than the general population. The aim of this review is to summarize suicidal behavior, associated risk factors, and risk populations among PLHIV. Research studies in six databases from January 1, 1988, to July 8, 2021, were searched using keywords that included "HIV," "suicide," and "risk factors." The study design, suicide measurement techniques, risk factors, and study findings were extracted. A total of 193 studies were included. We found that the Americas, Europe, and Asia have the highest rates of suicidal behavior. Suicide risk factors include demographic factors, mental illness, and physiological, psychological, and social support. Depression is the most common risk factor for PLHIV, with suicidal ideation and attempt risk. Drug overdosage is the main cause of suicide death. In conclusion, the current study found that PLHIV had experienced a high level of suicidal status. This review provides an overview of suicidal behavior and its risk factors in PLHIV with the goal of better managing these factors and thus preventing death due to suicide.
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Affiliation(s)
- Yi-Tseng Tsai
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Sriyani Padmalatha K. M.
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Operating Room Department, National Hospital of Sri Lanka, Colombo, Sri
Lanka
| | - Han-Chang Ku
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
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Molebatsi K, Ho-Foster A, Ntsayagae E, Bikimane B, Bauer AM, Suleiman K, Acosta E, Beidas R, Schnoll R. Implementation Planning for Integrating Depression Screening in Diabetes Mellitus and HIV Clinics in Botswana. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:384-393. [PMID: 36340843 PMCID: PMC9628413 DOI: 10.1007/s43477-022-00062-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Depression is highly prevalent and, when comorbid with other medical conditions, can worsen health outcomes. Implementing routine depression screening within medical clinics can ensure that patients receive suitable treatment and improve overall health outcomes. Unfortunately, depression screening within medical settings is rare, particularly in low- and middle-income countries. This qualitative study evaluated patient and clinician perspectives on implementing depression screening within HIV and diabetes clinics in Botswana. Seven clinicians and 23 patients within these clinics were purposively selected and interviewed using a guide informed by the Consolidated Framework for Implementation Research (CFIR) to understand barriers and facilitators to depression screening in medical clinics in Botswana. Interviews were recorded, transcribed, and analyzed using NVivo. Three general themes emerged: (1) Appropriateness and Acceptability: attitudes and beliefs from clinicians and patients about whether depression screening should occur in this setting; (2) Stigma as an important barrier: the need to address the negative associations with depression to facilitate screening; and (3) Recommendations to facilitate screening including improving knowledge and awareness about depression, offering incentives to complete the screening, providing staff training, ensuring resources for treatment, the need to preserve confidentiality, and utilizing leadership endorsement. These results offer insights into how to implement depression screening within medical clinics in Botswana. These results can help design implementation strategies to increase depression screening in these clinics, which can be tested in future studies. Supplementary Information The online version contains supplementary material available at 10.1007/s43477-022-00062-3.
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Affiliation(s)
- Keneilwe Molebatsi
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Ari Ho-Foster
- Research and Graduate Studies Office, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Esther Ntsayagae
- School of Nursing, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Boikanyo Bikimane
- Ministry of Health and Wellness, Gaborone Health District, Government of Botswana, Gaborone, Botswana
| | - Anna-Marika Bauer
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA 19143 USA
| | | | - Erika Acosta
- University of Pennsylvania, Philadelphia, PA USA
| | - Rinad Beidas
- Departments of Psychiatry, Medical Ethics and Health Policy, and Medicine, Penn Implementation Science Center (PISCE@LDI), Penn Medicine Nudge Unit, Center for Health Incentives and Behavioral Economics (CHIBE), Leonard Davis Institute of Health Economics, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Robert Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA USA
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Olashore AA, Paruk S, Tshume O, Chiliza B. Depression and suicidal behavior among adolescents living with HIV in Botswana: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2022; 16:62. [PMID: 35906651 PMCID: PMC9336130 DOI: 10.1186/s13034-022-00492-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Depression and suicidal behavior are the main causes of disability and morbidity, especially in adolescents living with HIV (ALWHIV). Data regarding these are lacking in Botswana, a country with a predominantly youthful population and ranked among the top four in the world most affected by HIV. Therefore, the present study aimed to estimate the prevalence of depression and suicidal behavior and explore their associated factors in Botswana ALWHIV. METHODS Responses were obtained from 622 ALWHIV using the DSM-5 and the Mini-International Neuropsychiatric Interview for Children and Adolescents. RESULTS The mean age (SD) of the participants was 17.7 (1.60) years and more males (54.3%) participated than females. Depression and suicidal behavior rates among adolescents were 23% and 18.9%, respectively. Female participants were more likely to be depressed (AOR = 1.96; 95% CI 1.11-3.45) and have suicidal behaviour (AOR = 6.60; 95% CI 3.19-13.7). Loss of mother (AOR = 2.87; 95% CI 1.08-7.62) and viral load of 400 copies and above (AOR = 5.01; 95% CI 2.86-8.78) were associated with depression. Alcohol use disorder (AOR = 3.82; 95% CI 1.83-7.96) and negative feelings about status (AOR = 8.79; 95% CI 4.62-16.7) were associated with suicidal behavior. Good support (AOR = 0.42; 95% CI 0.23-0.76) and increased frequency of religious activities were protective (AOR = 0.33; 95% CI 0.14-0.79) against depression and suicidal behaviour, respectively. CONCLUSION Therefore, routine psychologic screening, which includes identifying psychological stressors and maladaptive coping, family and caregiver support services, and psychosocial support platforms, should be integrated into the management package for ALWHIV in Botswana.
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Affiliation(s)
- Anthony A. Olashore
- grid.7621.20000 0004 0635 5486Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana ,grid.16463.360000 0001 0723 4123Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- grid.16463.360000 0001 0723 4123Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Ontibile Tshume
- grid.463139.aBotswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana
| | - Bonginkosi Chiliza
- grid.16463.360000 0001 0723 4123Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Barchi F, Winter SC, Dougherty D, Ramaphane P, Solomon PL. The Association of Depressive Symptoms and Intimate Partner Violence Against Women in Northwestern Botswana. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:4787-4805. [PMID: 30095029 DOI: 10.1177/0886260518792986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although links between mental health and intimate partner violence (IPV) have been discussed extensively in the scholarly literature, little empirical data exist about these phenomena in Botswana. This study addressed this gap by examining the nature, extent, and risk factors associated with symptoms of major depressive disorders (MDD) using cross-sectional data collected in 2009-2010 in northwestern Botswana. A random sample of 469 women participated in semistructured interviews about their lives, health, and experiences with violence. Thirty-one percent of respondents were found to meet the symptom criteria for MDD. Factors associated with MDD included emotional or physical violence by an intimate partner and being in a relationship in which both partners consumed alcohol. One in five women reported a recent experience of emotional violence, while 37% of respondents reported recent physical IPV. Women who have experienced emotional or physical IPV in the last 12 months have 89% and 82% greater odds, respectively, of having symptoms of MDD (p < .05) than women who have not recently experienced either form of violence. Women in relationships in which both partners consumed alcohol had more than twice the odds of MDD compared with women in relationships where neither partner or only one partner drank. Given the significant association of violence, alcohol, and MDD, screening for all three conditions should be part of routine care in health care settings in Botswana. Interventions to reduce IPV and alcohol consumption may help alleviate the burden of MDD in women in this setting.
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Maphisa JM, Mogotsi OP, Machola OK, Maswabi KM, Motsamai TB, Mosupiemang B. Psychiatric epidemiological survey of university students in Botswana: rationale and methods of the Youth Mental Health Study (YMHS). BMJ Open 2020; 10:e038175. [PMID: 33060084 PMCID: PMC7566732 DOI: 10.1136/bmjopen-2020-038175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND While the burden of disease attributable to mental disorders in low/middle-income countries (LMICs) is lower than high-income countries, there is recognition that the dearth of evidence from the LMICs may underestimate the actual prevalence and burden associated with mental disorders. Such is likely the case for Botswana where there has been no nationally representative data on the prevalence of symptoms of mental disorders or even a subgroup estimation of mental disorders in the country. Thus, the Youth Mental Health Study (YMHS) aims to estimate the prevalence and identify predictors of symptoms of mental disorders among university students in Botswana to add to the evidence and contribute to the country's health service planning. METHODS The YMHS is a cross-sectional study of youth (18-29 years) attending six large universities (accounting for nearly half of the tertiary student population) in Botswana. A stratified sampling procedure with proportionate allocation and selection is used to select a representative sample of 1308 participants. An online survey comprising of a battery of reliable and validated self-report measures of symptoms of mental disorders is used. A developmental psychopathology framework is used in identifying the risk factors of mental disorders. Participant recruitment will span over 4 months beginning in February 2020. ETHICS AND DISSEMINATION The study has received ethics approval from the University of Botswana Institutional Review Board, and the Ministry of Health and Wellness. Participants will be provided with feedback of their own results. Aggregated findings will be disseminated to stakeholders in the tertiary education and health sector in Botswana, and through peer-reviewed journals, conference presentations and the media.
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Affiliation(s)
- J Maphisa Maphisa
- Department of Psychology, University of Botswana, Gaborone, Botswana
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Opondo PR, Olashore AA, Molebatsi K, Othieno CJ, Ayugi JO. Mental health research in Botswana: a semi-systematic scoping review. J Int Med Res 2020; 48:300060520966458. [PMID: 33115301 PMCID: PMC7607297 DOI: 10.1177/0300060520966458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/23/2020] [Indexed: 02/05/2023] Open
Abstract
Mental and substance use disorders are a leading cause of disability worldwide. Despite this, there is a paucity of mental health research in low- and middle-income countries, especially in sub-Saharan Africa. We carried out a semi-systematic scoping review to determine the extent of mental health research in Botswana. Using a predetermined search strategy, we searched the databases Web of Science, PubMed, and EBSCOhost (Academic Search Complete, CINAHL with Full Text, MEDLINE, MEDLINE with Full Text, MLA International Bibliography, Open Dissertations) for articles written in English from inception to June 2020. We identified 58 studies for inclusion. The most researched subject was mental health aspects of HIV/AIDS, followed by research on neurotic and stress-related disorders. Most studies were cross-sectional and the earliest published study was from 1983. The majority of the studies were carried out by researchers affiliated to the University of Botswana, followed by academic institutions in the USA. There seems to be limited mental health research in Botswana, and there is a need to increase research capacity.
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Affiliation(s)
- Philip R. Opondo
- Department of Psychiatry, Faculty of Medicine,
University of Botswana, Gaborone, Botswana
| | - Anthony A. Olashore
- Department of Psychiatry, Faculty of Medicine,
University of Botswana, Gaborone, Botswana
| | - Keneilwe Molebatsi
- Department of Psychiatry, Faculty of Medicine,
University of Botswana, Gaborone, Botswana
| | - Caleb J. Othieno
- Department of Psychiatry, Faculty of Medicine,
University of Botswana, Gaborone, Botswana
| | - James O. Ayugi
- Department of Psychiatry, Faculty of Medicine,
University of Botswana, Gaborone, Botswana
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Vavani B, Kraaij V, Spinhoven P, Amone-P'Olak K, Garnefski N. Intervention targets for people living with HIV and depressive symptoms in Botswana. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2020; 19:80-88. [PMID: 32200725 DOI: 10.2989/16085906.2020.1727933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: The prevalence of HIV in Botswana is high. Many people living with HIV (PLWH) suffer from depressive symptoms and have inadequate coping skills. Most PLWH do not receive adequate psychological treatment. Empirically based interventions for PLWH with depressive symptoms in Botswana should be developed, with a focus on improving coping skills. The present study was a first step towards this goal, by trying to identify targets for intervention. The study aimed to provide prevalence rates of depression among PLWH in Botswana, to assess their mental health treatment needs and wishes as expressed by themselves, and to study the relationships between cognitive and behavioural coping strategies and depressive symptoms.Method: A cross-sectional study was conducted. The sample consisted of 291 participants (73% female) from 8 HIV treatment centres from Botswana. Participants completed standardized questionnaires on depressive symptoms (CES-D) and coping skills (CERQ, BERQ). They also answered questions regarding their mental health care needs and wishes.Results: In total 43.4% of participants reported clinically significant depressive symptoms. The majority of participants indicated that they needed help with the following topics: feelings of depression, physical tension, finding new goals and coping with HIV. In addition, they indicated preferring a self-help programme in booklet format. Multiple regression analyses showed that the following coping strategies had significant relationships with depressive symptoms: rumination, catastrophising, withdrawal, positive refocusing and refocus on planning (the latter two negatively).Conclusion: Almost half of the PLWH reported depressive symptoms that were clinically significant. The findings suggested that an intervention for PLWH with depressive symptoms in Botswana should preferably be a self-help programme presented in booklet format. With regard to content, the results confirmed that the intervention should focus on specific coping skills. In addition, elements like goal finding and strategies to reduce physical tension should be added.
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Affiliation(s)
- Boitumelo Vavani
- Psychology Department, University of Botswana, Gaborone, Botswana.,Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Vivian Kraaij
- Clinical Psychology, Leiden University, Leiden, Netherlands
| | | | - Kennedy Amone-P'Olak
- Department of Psychology, University of Witwatersrand, Johannesburg, South Africa
| | - Nadia Garnefski
- Psychology Department, University of Botswana, Gaborone, Botswana
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Vavani B, Kraaij V, Spinhoven P, Garnefski N. A booklet self-help intervention to reduce depressive symptoms among people living with HIV in Botswana: study protocol for a randomized controlled trial. Trials 2019; 20:486. [PMID: 31399138 PMCID: PMC6688259 DOI: 10.1186/s13063-019-3584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 07/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The treatment of mental health issues among people living with HIV (PLH) in Botswana is yet to be addressed. A recent study revealed that depressive symptoms are highly prevalent in a sample of PLH in Botswana. Based on empirical findings of a study that investigated intervention targets for PLH in Botswana, a self-help program with coaching in booklet format in the Setswana and English languages was developed, composed of cognitive behavioral techniques, coping skills interventions, and goal adjustment training. We will investigate the program for effectiveness in the treatment of depressive symptoms among PLH. Additionally, we will investigate treatment moderators and mediators. This paper describes the study protocol. METHODS/DESIGN A randomized controlled trial will be conducted to compare the booklet self-help program with coaching with an attention-only control condition, by including pre-test, post-test, and follow-up assessments. We aim to enroll 200 participants with mild to moderate depressive symptoms into the study. The self-help program contains the following main components: activation, relaxation, changing maladaptive cognitions, and the attainment of new personal goals. This content is covered over six lessons to be completed in a maximum of 8 weeks. It uses a combination of psycho-education, assignments, and exercises. The participants will work on the program 1-2 h every week for 6 weeks (maximum 8 weeks). Coaches will offer support and motivate the participants. For both groups, depressive symptoms and possible mediators will be measured three times during the intervention, and at pre-test, post-test, and follow-up. DISCUSSION If the intervention is found to effectively treat depressive symptoms, it will be implemented and thus help improve the psychological health of PLH in Botswana. TRIAL REGISTRATION Netherlands Trial Register, NTR7428 . Registered on 23 August 2018.
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Affiliation(s)
- Boitumelo Vavani
- Department of Psychology, University of Botswana, P/Bag UB00705, Gaborone, Botswana
| | - Vivian Kraaij
- Leiden University, PO Box 9500, 2300 RB Leiden, Netherlands
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Pottinger AM, Carroll K. Reproductive needs of PLHIV in Jamaica: relationship between fertility desire, motives and depression. J Reprod Infant Psychol 2019; 38:38-48. [PMID: 30939927 DOI: 10.1080/02646838.2019.1599334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background/objective: Advances in antiretroviral therapy and assisted reproduction technology which allow for longer and healthier lives and safer conception options necessitate a new understanding of the sexual and reproductive needs of persons living with HIV (PLHIV). This study examines fertility desire and motives for having children among PLHIV in Jamaica and explores the association with depressive symptoms.Methods: In a cross-sectional study, 251 PLHIV in their reproductive years voluntarily completed an interviewer-administered questionnaire. SPSS analyses involved bivariate and logistic regression models significant at p < .05.Results: A desire to have children was expressed by 66% (n = 166), mostly males and persons younger than 40 years. Of those in a current relationship (n = 126), not having previous children best predicted fertility desire (p = .001; CI 0.04-0.44) as well as motives to conceive (p = .02; CI 0.01-0.66). PLHIVs in their reproductive years who are at depression risk are those in a sero-discordant relationship (p = .01; CI 1.48-30.22) and who have been diagnosed between 1 and 4 years (p = .05; CI 0.01-1.04).Conclusions: HIV status does not dampen the desire to have future children. There is need to evaluate the sexual, reproductive and mental health needs of PLHIV.
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Affiliation(s)
- Audrey M Pottinger
- Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Kamali Carroll
- The Hugh Wynter Fertility Management Unit, The University of the West Indies, Kingston, Jamaica
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Bigna JJ, Tounouga DN, Kenne AM, Djikeussi TK, Foka AJ, Um LN, Asangbeh SL, Sibetcheu AT, Kaze AD, Ndangang MS, Nansseu JR. Epidemiology of depressive disorders in people living with HIV in Africa: a systematic review and meta-analysis: Burden of depression in HIV in Africa. Gen Hosp Psychiatry 2019; 57:13-22. [PMID: 30654293 DOI: 10.1016/j.genhosppsych.2018.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The burden of HIV infection is higher in Africa where 70% of people living with HIV (PLHIV) resides. Since depression can negatively impact the course of HIV infection, it is therefore important to accurately estimate its burden among PLHIV in the continent. METHODS We searched multiple databases to identify articles published between January 2000 and February 2018, reporting the prevalence of (major) depressive disorders in PLHIV residing in Africa. We used a random-effects meta-analysis model to pool studies. RESULTS Overall, 118 studies (60,476 participants, 19 countries) were included. There was no publication bias. The overall prevalence estimates of depressive disorders and probable major depressive disorders were 36.5% (95% CI 32.3-41.0; 101 studies) and 14.9% (12.1-17.9; 55 studies) respectively. The heterogeneity of the overall prevalence of depressive disorders was significantly explained by screening tool used, period (higher prevalence in recent studies) and distribution in sub-regions. The study setting, site, CD4 cell counts, age, sex, proportion of people with undetectable viral load were not sources of heterogeneity. CONCLUSIONS This study shows that more than one third of PLHIV face depressive disorders and half of them having major form, with heterogeneous distribution in the continent. As such, depressive disorders deserve more attention from HIV healthcare providers for improved detection and overall proper management.
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Affiliation(s)
- Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaounde, Cameroon.
| | | | | | - Tatiana K Djikeussi
- Department for the Control of Disease, Epidemics and Pandemics Diseases, Ministry of Public Health, Yaounde, Cameroon
| | - Audrey Joyce Foka
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Lewis N Um
- Mfou District Hospital, Ministry of Public Health, Mfou, Cameroon
| | - Serra Lem Asangbeh
- Department of Clinical Research, National Agency on Research for HIV and Viral Hepatitis, Yaounde, Cameroon
| | - Aurelie T Sibetcheu
- Department of Pediatrics and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon
| | - Arnaud D Kaze
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | - Marie S Ndangang
- Department of Medical Information and Informatics, Rouen University Hospital, Rouen, France
| | - Jobert Richie Nansseu
- Department for the Control of Disease, Epidemics and Pandemics Diseases, Ministry of Public Health, Yaounde, Cameroon; Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon
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Lu HF, Sheng WH, Liao SC, Chang NT, Wu PY, Yang YL, Hsiao FH. The changes and the predictors of suicide ideation and suicide attempt among HIV-positive patients at 6-12 months post diagnosis: A longitudinal study. J Adv Nurs 2018; 75:573-584. [PMID: 30334591 DOI: 10.1111/jan.13883] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/19/2018] [Accepted: 09/13/2018] [Indexed: 02/05/2023]
Abstract
AIMS This study examined the changes and the predictors of suicide ideation/suicide attempt and the moderating effects of psychosocial factors on the suicide ideation/suicide attempts among human immunodeficiency virus (HIV)-positive patients at 6-12 months post-diagnosis. BACKGROUND Suicide behaviours are prevalent among newly diagnosed HIV-positive patients, but the changes in suicide behaviours after diagnosis and the role of psychosocial factors in these behaviours are not well studied. DESIGN This study used a prospective longitudinal design. METHODS A total of 113 participants diagnosed as HIV-positive for 6-12 months were recruited from the outpatient department. Data were collected from June 2015 - October 2016. They were asked to complete Beck's Scale for Suicide Ideation, the Beck Depression Inventory-II, the Body Image Scale, the Meaning in Life Questionnaire and the Multidimensional Scale of Perceived Social Support at baseline, the third month and the sixth month. RESULTS The results showed the high occurrence rates for suicide ideation ranging from 27.2%, 21.6%, and 25.8% and suicide attempt ranging from 14.7%, 8.6%, and 13.3% at the baseline, the third month and the sixth month, respectively. The education level, social support from family and depressive symptoms were the predictors of suicide ideation. The history of depression disorders, depressive symptoms and social support from friends significantly predicted suicide attempt. Meaning in life-presence moderated the relationship between depressive symptoms and suicide ideation. CONCLUSIONS After diagnosed for 6-12 months, HIV-positive patients remain the high-risk group for suicide ideation and attempt. Suicide intervention targeting the risk and protective factors are required for HIV-positive patients.
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Affiliation(s)
- Hsing-Fei Lu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Nien-Tzu Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Ying Wu
- Department of Infectious disease, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Nursing Department, National Taiwan University Hospital, Taipei, Taiwan
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Coleman CL. Predictors of Depression among Seropositive Batswana Men and Women: A Descriptive Correlational Study. Arch Psychiatr Nurs 2016; 30:736-739. [PMID: 27888968 DOI: 10.1016/j.apnu.2016.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/21/2016] [Accepted: 07/09/2016] [Indexed: 11/25/2022]
Abstract
The purpose of this descriptive correlational study was to describe predictors of depressive symptoms among N=70 seropositive Botswana men and women residing in Gaborne, Botswana. A demographic questionnaire, the Center for Epidemiologic Studies Depression Scale, (CESD-D), and the SF-36 [Quality of life] were administered. The questionnaires were translated and back translated in Setswana and administered by Batswana men and women. The results of the regression analyses resulted in two calculated models. In the first Model energy/fatigue explained 46% of the variance in depressive symptoms (P=.000), and in the second Model energy/fatigue and role limitations on emotional well-being explained 50% of the variance in depressive symptoms respectively. The study findings underscore the need for mental health services for seropositive Batswana men and women.
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Ndubuka NO, Lim HJ, van der Wal DM, Ehlers VJ. Health-related quality of life of antiretroviral treatment defaulters in Botswana. South Afr J HIV Med 2016; 17:475. [PMID: 29568617 PMCID: PMC5843183 DOI: 10.4102/sajhivmed.v17i1.475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 09/05/2016] [Indexed: 12/04/2022] Open
Abstract
Background Antiretroviral therapy (ART) improves patients’ health-related quality of life (HRQoL). Defaulting from ART has detrimental consequences, including the development of viral resistance, treatment failure and increased risks of disease progression. Little is known about the quality of life of ART defaulters and reasons for discontinuing their ART. Objectives This study sought to measure the HRQoL of ART patients in Botswana who were on ART for up to 5 years but had discontinued treatment for at least 3 months, and to identify factors associated with ART defaulting. Method We conducted a cross-sectional study with 104 eligible respondents in four ART clinics in south eastern Botswana. We assessed respondents’ HRQoL using the World Health Organization Quality of Life Questionnaire for HIV short form. Clinical information was obtained from respondents’ medical records. Data were analysed using SAS version 9.2. Results Reasons for discontinuing ART were inaccessible clinics (22.4%), feeling better (21.4%), running out of pills (11.2%), depression (8.2%), lack of care and/or support (8.2%), failure to understand instructions (7.7%), medications’ side effects (6.1%) and alcohol abuse (3.1%). In multivariate analyses, respondents aged 36–45 years had a 0.03 lower independence HRQoL score compared to those aged 35 and younger (β = -0.03; 95% confidence interval: -1.72, -1.66). Despite defaulting from their ART, respondents’ calculated HRQoL scores were moderate. Conclusion This study highlights the need to enhance ART adherence in order to improve the HRQoL of people living with HIV and/or AIDS.
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Affiliation(s)
- Nnamdi O Ndubuka
- Department of Health Studies, University of South Africa, South Africa.,Northern Inter-Tribal Health Authority, Prince Albert, South Africa
| | - Hyun J Lim
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada
| | | | - Valerie J Ehlers
- Department of Health Studies, University of South Africa, South Africa
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Serafini G, Montebovi F, Lamis DA, Erbuto D, Girardi P, Amore M, Pompili M. Associations among depression, suicidal behavior, and quality of life in patients with human immunodeficiency virus. World J Virol 2015; 4:303-312. [PMID: 26279991 PMCID: PMC4534821 DOI: 10.5501/wjv.v4.i3.303] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 05/19/2015] [Accepted: 08/03/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus (HIV) patients.
METHODS: A detailed MEDLINE search was carried out to identify all articles and book chapters in English published from January 1995 to January 2015.
RESULTS: Based on the main findings, the prevalence of major depressive disorder (MDD) ranged from 14.0% to 27.2%. Furthermore, the prevalence of suicidal ideation varied from 13.6% to 31.0% whereas, attempted suicides were reported to range from 3.9% to 32.7%. Interestingly, various associated risk factors for both depression and suicide were identified in HIV patients. Finally, consistent associations were reported among MDD, suicidal ideation, and poor quality of life in individuals living with HIV.
CONCLUSION: Although additional studies are needed to elucidate this complex association, our results suggest the importance of early detection of both MDD and suicidality in patients living with HIV.
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Korb I, Plattner IE. Suicide ideation and depression in university students in Botswana. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2014.997010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Iram Korb
- Department of Psychology, University of Botswana, Gaborone, Botswana
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