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

BMC Psychiatry

Research Article

Savio Rodrigues¹  Vikram Patel²  Melanie Abas³  Martin Prince³  Rosie Mayston³  Ramesh Paranjape⁴  Priya Korgaonkar⁵ 

[1] Department of Microbiology, Goa Medical College and Hospital, Bambolim, Tiswadi, Goa, India;Department of Nutrition and Public Health Intervention Research, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK;Sangath, North Goa: 841/1, Near Electricity Department, Alto Porvorim, Bardez, Goa, India;Health Service & Population Research Department, Institute of Psychiatry, Kings College London, SE5 8AF, London, UK;National AIDS Research Institute, 73, 'G'-Block, MIDC, 411 026, Bhosari Pune, India;Sangath, North Goa: 841/1, Near Electricity Department, Alto Porvorim, Bardez, Goa, India;

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

DOI  :  10.1186/1471-244X-14-188

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

来源: Springer

【 摘 要 】

BackgroundSuccessful 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.MethodsThe 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.ResultsAmong 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.ConclusionsAlthough 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】

CC BY   
© Mayston et al.; licensee BioMed Central Ltd. 2014