Amsterdam 2015
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| Abstract #2214 - Sisters unite - Women and HIV | ||||
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Session: 43.4: Sisters unite - Women and HIV (Parallel) on Thursday @ 16.30-18.00 in C002 Chaired by Authors: Presenting Author: Dr Aoife Molloy - Royal Free Hospital, United Kingdom |
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| Additional Authors: | ||||
| Aim: Mental health comorbidity has been established in many people with HIV infection. Mental health problems may increase HIV infection risk and affect coping and adjustment to illness after diagnosis. The effects of mental health burden for women with HIV need to be understood to ensure appropriate service provision. | ||||
| Method / Issue: With ethical approval, researchers attended HIV clinics and invited all women attenders to participate. A total of 272 women were approached and screened for eligibility (age, language fluency, wellness). Of the eligible participants (n=251), 170 accepted (67.7% response rate). Usable complete questionnaires were received from 140 women (55.8% response rate from all approached). Questionnaires included demographics, service provision and evaluation, validated measures for Anxiety (GAD Spitzer et al 2006), Depression (PHQ-9 Kroenke et al 2001), Symptom experience (MSAS Chang et al 2000) Female sexual functioning (FSFI Index Safarinejad 2006) and medication adherence for those on ART (self-report with non-adherent coded as missing any doses in the previous week). A mental health burden scale was created describing those who had no mental health burden, those who scored above the cut off for one or more scores on depression, anxiety and suicidal thoughts. | ||||
| Results / Comments: Overall, 140 women aged 21-66 years participated (X age = 44.1,SD = 10.1). Just over half were Black African (55.1%), 14.8% were from other Black backgrounds, 25% were White and 5.1 % were from ethnic minorities. Most women (51.5%) were currently in a relationship. 33.1% had a university degree and 18.1% a postgraduate degree. The mean anxiety score for women who completed the scale (n=107) was 4.48 (SD= 5.65) which is within the normal range. Although the majority were not at risk for an anxiety disorder (65.4%), 14.9% scored above the cut off point for mild anxiety, 11.2% for moderate anxiety and 8.4% for severe anxiety. Symptom distress was notable. The mean MSAS score for the psychological subscale was 6.45 (SD=2.86) the mean score for the physical subscale was 18.2 (SD=8.25) and the mean score for the Global Distress Index was 22.44 (SD=10.33). Half of the participants (n=69, 56.6%) reported that they had suicidal thoughts in the past week. For women who completed the PHQ-9 scale for depression (n=95), 55.8% showed no risk for depression and the remainder showed mild (29.5%) or moderate to severe risk (14.8%). Notable levels of mild sexual dysfunction were recorded. There were no significant differences on mental health measures according to age, ethnicity or relationship status. Ancova analysis (no MH burden, single burden, multiple burden) shows that mental health burden was significantly associated with symptom distress (F=3.46 p=.02). These were also significant for physical (f=3.4 p=.03) and psychological symptoms (f=15.3 p<.0001). Mental health burden was significantly associated with sexual dysfunction (f=5.3 p=.004) and medication adherence (X2=28.1 p<.0001). | ||||
| Discussion: The study shows the range of mental health burdens for women with HIV infection and also shows the added burden of multiple mental health challenges. The direction of the associations cannot be established within a cross sectional study, but clearly symptom distress is linked to mental health burden, as is adherence and sexual dysfunction. The data seems to indicate lower associations with single mental health challenges than those who have multiple burdens (despite small sample size). Early identification and intervention for mental health problems needs to be integrated into comprehensive care to ensure the wellbeing, symptom management, adherence and psychosexual adjustment for women with HIV. | ||||
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