Barcelona 2013
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| Abstract #495 - Mental Health | ||||
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Session: 39.2: Mental Health (Parallel) on Tuesday @ 16.30-18.30 in Teatre Chaired by Sue Gibbons, Jordi Blanch Authors: Presenting Author: Prof Lorraine Sherr - UCL, United Kingdom |
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| Additional Authors: Lic Juan Sotelo, Lic Daniel Palacio, Lic Fernando D`Elio, Lic Luciana Betti, Dr Silvana Weller, Lic Julia Recchi, Dr Carlos Falistocco, | ||||
| Aim: There is a high level of co-morbidity between HIV/AIDS and mental health disorders. There is little knowledge about the prevalence and impact of poor mental health in families affected by HIV and how to improve outcomes in the context of this double burden. The objective of this study was to assess the level of depression and suicidal ideation in carers of children affected by HIV attending community-based programmes in South Africa and Malawi. | ||||
| Method / Issue: A sample of 989 carers were recruited from 28 randomly selected community HIV organisations across South Africa and Malawi. Depression was screened for using the Shona Symptom Questionnaire (SSQ) with a cut-off for clinical caseness of 7/8. Suicidality was measured using a question about suicidal ideation from the Patient Health Questionnaire. Chi-square tests were conducted to compare mental health outcomes with family and community factors. | ||||
| Results / Comments: The carers in the sample had a mean age of 44 years and 94.9% were women. The prevalence of carers reporting depressive symptoms above the cut-off was 28.1%. Moreover, 12.3% of carers reported experiencing suicidal ideation. Women were more likely to have depression (0.051) and suicidal ideation (p<0.001). Carers with depression were significantly more likely to be living in with someone with HIV (p=0.008) and have a family member who had been unwell in the past 3 months (p=0.001). Suicidal ideation was more common in carers who had no employed household members (p<0.004), and had a family member who had been ill in the past 3 months (p<0.001). Carers were more likely to have depression if they had experienced violence in their homes in the past year (p=0.028) and lived in communities where family members had been exposed to violence (p=0.030). Carers with depression were more likely to use disciplinary measures that involved physical violence (p=0.007) and psychological threats (p<0.001) with their children, as were carers with suicidal ideation (physical violence p=0.008; psychological threats p=0.001). Carers with depression were more likely to have children who were in poor health and had a developmental disability (p<0.001). Carers with suicidal ideation were more likely to have children who were also experiencing suicidal ideation (p=0.016), higher levels of hunger (p<0.001), and developmental disability (0.001). Carers living in communities with a high level of concern for children affected by HIV/AIDS were less likely to have depression (p<0.001), while carers living in communities where these children were rejected were more likely to have depression scores higher than the cut-off (p<0.001). Suicidal ideation was more common in carers who live in communities where adults are not concerned about the well-being of children affected by HIV/AIDS (p=0.000), or where communities reject these children (0.001). | ||||
| Discussion: The mental health burden of HIV is linked to socio-economic factors, family illness and bereavement, and poor child outcomes. It is exacerbated by community stigma while community support is associated with better mental health outcomes. Causality cannot be established, but community organisations may be well placed to address the double epidemic of HIV and poor mental health. There is a need for evidence about what types of community input improve outcomes for families who are affected by HIV. | ||||
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