Psychological predictors for attendance of post-HIV test counselling and linkage to care: the Umeed cohort study in Goa, India

BMC Psychiatry

Martin Prince³  Savio Rodrigues¹  Ramesh Paranjape⁴  Priya Korgaonkar²  Melanie Abas³  Vikram Patel²  Rosie Mayston³ 

[1] Department of Microbiology, Goa Medical College and Hospital, Bambolim, Tiswadi Goa, India;Sangath, North Goa: 841/1, Near Electricity Department, Alto Porvorim, Bardez-Goa, India;Health Service & Population Research Department, Institute of Psychiatry, Kings College London, London SE5 8AF, UK;National AIDS Research Institute, 73, 'G'-Block, MIDC, Bhosari Pune 411 026, India

关键词: India;    Cognitive impairment;    HIV testing;    Anxiety;    Depression;    Linkage to care;   

Others  :  1123491
DOI  :  10.1186/1471-244X-14-188

 received in 2014-03-25, accepted in 2014-06-19,  发布年份 2014

【 摘 要 】

Background

Successful linkage to care is increasingly recognised as a potentially important factor in determining the success of Antiretroviral Therapy treatment programmes. However, the role of psychological factors during the early part of the continuum of care has so far been under-investigated. The objective of the Umeed study was to evaluate the impact of Common Mental Disorder (CMD), hazardous alcohol use and low cognitive functioning upon attendance for post-test counselling and linkage to care among people attending for HIV-testing in Goa, India.

Methods

The study was a prospective cohort design. Participants were recruited at the time of attending for testing and were asked to complete a baseline interview covering sociodemographic characteristics and mental health exposures. HIV status, post-test counselling (PTC) and Antiretroviral Treatment (ART) Centre data were extracted from clinical records.

Results

Among 1934 participants, CMD predicted non-attendance for PTC (adjusted OR = 0.51, 0.21-0.82). There was tentative evidence of an association between hazardous alcohol use and non-attendance for PTC (adjusted OR = 0.69, 0.45-1.02). There was no evidence of an association between CMD caseness and attendance for ART. However, post-hoc analyses showed an association between increasing symptoms of CMD and non-attendance.

Conclusions

Although participation rates were high (86%), non-participation was a possible source of bias. Cognitive tests had not been previously validated in a young population in Goa. The context in which cognitive testing took place may have contributed to the high prevalence of low scores. Findings suggest the need to move towards a broader conceptualisation of the interrelationship between mental health and HIV. It may be important to consider the impact of symptoms of depression and anxiety at every stage of the continuum of care, including immediately after diagnosis and when initiating contact with treatment services.

【 授权许可】

   
2014 Mayston et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Lawn SD, Harries AD, Anglaret X, Myer L, Wood R: Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa. AIDS 2008, 22(15):1897-1908.
• [2]Lawn SD, Harries AD, Wood R: Strategies to reduce early morbidity and mortality in adults receiving antiretroviral therapy in resource-limited settings. Curr Opin HIV AIDS 2010, 5(1):18-26.
• [3]Robertson K, Liner J, Heaton R: Neuropsychological assessment of HIV-infected populations in international settings. Neuropsychol Rev 2009, 19(2):232-249.
• [4]Bing EG, Burnam MA, Longshore D, Fleishman JA, Sherbourne CD, London AS, Turner BJ, Eggan F, Beckman R, Vitiello B, Morton SC, Orlando M, Bozzette SA, Ortiz-Barron L, Shapiro M: Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry 2001, 58(8):721-728.
• [5]Mayston R, Kinyanda E, Chishinga N, Prince M, Patel V: Mental disorder and the outcome of HIV/AIDS in low-income and middle-income countries: a systematic review. AIDS 2012, 26(Suppl 2):S117-135.
• [6]Azar MM, Springer SA, Meyer JP, Altice FL: A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug Alcohol Depend 2010, 112(3):178-193.
• [7]Hinkin CH, Hardy DJ, Mason KI, Castellon SA, Durvasula RS, Lam MN, Stefaniak M: Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS 2004, 18(Suppl 1):S19-25.
• [8]Ickovics JR, Hamburger ME, Vlahov D, Schoenbaum EE, Schuman P, Boland RJ, Moore J: Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: longitudinal analysis from the HIV Epidemiology Research Study. JAMA 2001, 285(11):1466-1474.
• [9]Sahay S, Phadke M, Brahme R, Paralikar V, Joshi V, Sane S, Risbud A, Mate S, Mehendale S: Correlates of anxiety and depression among HIV test-seekers at a Voluntary Counseling and Testing facility in Pune, India. Qual Life Res 2007, 16(1):41-52.
• [10]Rochat TJ, Richter LM, Doll HA, Buthelezi NP, Tomkins A, Stein A: Depression among pregnant rural South African women undergoing HIV testing. JAMA 2006, 295(12):1376-1378.
• [11]Ramirez-Avila L, Regan S, Giddy J, Chetty S, Ross D, Katz JN, Freedberg KA, Walensky RP: Losina E. Bassett IV: Depressive Symptoms and Their Impact on Health-seeking Behaviors in Newly-diagnosed HIV-infected Patients in Durban, South Africa. AIDS Behav; 2012.
• [12]Spitzer RL, Kroenke K, Williams JB: Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA 1999, 282(18):1737-1744.
• [13]Patel V, Araya R, Chowdhary N, King M, Kirkwood B, Nayak S, Simon G, Weiss HA: Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med 2008, 38(2):221-228.
• [14]Lowe B, Decker O, Muller S, Brahler E, Schellberg D, Herzog W, Herzberg PY: Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care 2008, 46(3):266-274.
• [15]Lowe B, Grafe K, Zipfel S, Spitzer RL, Herrmann-Lingen C, Witte S, Herzog W: Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire, a screening question, and physicians' diagnosis. J Psychosom Res 2003, 55(6):515-519.
• [16]Hettema JM: The nosologic relationship between generalized anxiety disorder and major depression. Depress Anxiety 2008, 25(4):300-316.
• [17]Pal HR, Jena R, Yadav D: Validation of the Alcohol Use Disorders Identification Test (AUDIT) in urban community outreach and de-addiction center samples in north India. J Stud Alcohol 2004, 65(6):794-800.
• [18]D'Costa G, Nazareth I, Naik D, Vaidya R, Levy G, Patel V, King M: Harmful alcohol use in Goa, India, and its associations with violence: a study in primary care. Alcohol Alcohol 2007, 42(2):131-137.
• [19]Nayak MB, Bond JC, Cherpitel C, Patel V, Greenfield TK: Detecting alcohol-related problems in developing countries: a comparison of 2 screening measures in India. Alcohol Clin Exp Res 2009, 33(12):2057-2066.
• [20]Allen JP, Litten RZ, Fertig JB, Babor T: A review of research on the Alcohol Use Disorders Identification Test (AUDIT). Alcohol Clin Exp Res 1997, 21(4):613-619.
• [21]White DA, Taylor MJ, Butters N, Mack C, Salmon DP, Peavy G, Ryan L, Heaton RK, Atkinson JH, Chandler JL, Grant I: Memory for verbal information in individuals with HIV-associated dementia complex. HNRC Group. J Clin Exp Neuropsychol 1997, 19(3):357-366.
• [22]Ganguli M, Seaberg EC, Ratcliff GG, Belle SH, DeKosky ST: Cognitive stability over 2 years in a rural elderly population: the MoVIES project. Neuroepidemiology 1996, 15(1):42-50.
• [23]Prince M, Acosta D, Chiu H, Scazufca M, Varghese M: Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet 2003, 361(9361):909-917.
• [24]Kawichai S, Celentano DD, Chaifongsri R, Nelson KE, Srithanaviboonchai K, Natpratan C, Byerer C, Khamboonruang C, Tantipiwatanaskul P: Profiles of HIV voluntary counseling and testing of clients at a district hospital, Chiang Mai Province, northern Thailand, from 1995 to 1999. J Acquir Immune Defic Syndr 2002, 30(5):493-502.
• [25]Mmbaga EJ, Leyna GH, Mnyika KS, Hussain A, Klepp KI: Prevalence and predictors of failure to return for HIV-1 post-test counseling in the era of antiretroviral therapy in rural Kilimanjaro, Tanzania: challenges and opportunities. AIDS Care 2009, 21(2):160-167.
• [26]Mwamburi DM, Dladla N, Qwana E, Lurie MN: Factors associated with wanting to know HIV results in South Africa. AIDS Patient Care STDS 2005, 19(8):518-525.
• [27]Ramon R, La Ruche G, Sylla-Koko F, Boka-Yao A, Bonard D, Coulibaly IM, Welffens-Ekra C, Dabis F: HIV counseling and testing: behavior and practices of women of childbearing age in Abidjan, Cote d'Ivoire. DYSCER-CI Group. J Acquir Immune Defic Syndr Hum Retrovirol 1998, 17(5):470-476.
• [28]Desai MM, Rosenheck RA: HIV testing and receipt of test results among homeless persons with serious mental illness. Am J Psychiatry 2004, 161(12):2287-2294.
• [29]Ellen JM, Liang TS, Jacob CA, Erbelding E, Christmyer C: Post-HIV test counselling of clients of a mobile STD/HIV clinic. Int J STD AIDS 2004, 15(11):728-731.
• [30]Chan E, McNulty A, Tribe K: Who returns for HIV screening test results? Int J STD AIDS 2007, 18(3):171-174.
• [31]Cain R, Jackson R, Prentice T, Collins E, Mill J, Barlow K: The experience of HIV diagnosis among Aboriginal people living with HIV/AIDS and depression. Qual Health Res 2013, 23(6):815-824.
• [32]Jaggers JR, Dudgeon WD, Burgess S, Phillips KD, Blair SN, Hand GA: Psychological Correlates of HIV-Related Symptom Distress. J Assoc Nurses AIDS Care 2013, 25(4):309-317.
• [33]Bhatia R, Hartman C, Kallen MA, Graham J, Giordano TP: Persons newly diagnosed with HIV infection are at high risk for depression and poor linkage to care: results from the Steps Study. AIDS Behav 2011, 15(6):1161-1170.
• [34]Mayston R, Patel V, Abas M, Korgaonkar P, Paranjape R, Rodrigues S, Prince M: Symptoms of common mental disorder and cognitive associations with seropositivity among a cohort of people coming for testing for HIV/AIDS in Goa, India: a cross-sectional survey. BMC Public Health 2013, 13:204.
• [35]Iudicello JE, Woods SP, Parsons TD, Moran LM, Carey CL, Grant I: Verbal fluency in HIV infection: a meta-analytic review. J Int Neuropsychol Soc 2007, 13(1):183-189.
• [36]Gonzalez JS, Penedo FJ, Llabre MM, Duran RE, Antoni MH, Schneiderman N, Horne R: Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence. Ann Behav Med 2007, 34(1):46-55.
• [37]Horne R, Cooper V, Gellaitry G, Date HL, Fisher M: Patients' perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: the utility of the necessity-concerns framework. J Acquir Immune Defic Syndr 2007, 45(3):334-341.