Psychiatric disorders in HIV-positive individuals in urban Uganda
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There is a well-documented strong association between depressive disorders and HIV/AIDS (e.g. Maj et al, 1994; Perkins et al, 1994; Judd et al, 1997). High levels of depression are seen in people with HIV/AIDS attending primary care clinics (Savetsky et al, 2001) and in HIV medical clinics (Lyketsos et al, 1994a). There appears to be a sustained rise in depressive symptoms as AIDS develops (Lyketsos et al, 1994b). Depression is also associated with HIV-related risk behaviours among those without HIV (Kelly et al, 1993). Nevertheless, most persons affected by HIV/AIDS in Uganda do not receive any care for their mental health problems. The early cases of AIDS were described in Uganda, but there has been little work examining the existence of psychiatric disorders in AIDS/HIV in that country. The national rate of HIV at the end of 2003 was 4.1% (UNAIDS, 2004), but is as high as 13% in war-torn northern Uganda. Of adult deaths at Mulago Hospital, Kampala, 60-70% are attributable to HIV.Wilk & Bolton (2002) investigated how people in two districts of Uganda (Masaka and Rakai), which have been severely affected by HIV, perceive the mental health affects of the disease. The individuals interviewed described two independent depression-like syndromes resulting from the HIV epidemic and rates of depressive disorder were estimated to be 21% in these districts (Bolton et al, 2004). Anecdotal evidence also links HIV/AIDS to suicide in Uganda (Musisi et al, 2001; Kinyanda & Musisi, 2002).
- Medical and Health Sciences