Does social support affect depression in patients on antiretroviral treatment program in rural KwaZulu-Natal, South Africa?
Date
2010-04-15T08:57:12Z
Authors
Yeji, Francis Asepola
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Abstract
Good and quality social support has been positively associated with mental health and
researchers and clinicians are increasingly recognising the important protective role it plays
in people living with HIV/AIDS (PLWA).
We investigated whether the mental health (depression) of patients receiving antiretroviral
treatment (ART) in a public-sector treatment programme in the rural district of
Umkhanyakude, KwaZulu-Natal, South Africa is influenced by social support and
strategies to cope with HIV infection. Depression was assessed in a cross-section of 272
patients (mean age 38 years, age range 20-67 years) with the General Health Questionnaire
12 (GHQ12). A GHQ12 score of 4 or higher indicated mental health pathology
(depression), while lower scores indicated normal mental health.
We regressed depression on sex, age, marital status, education, household wealth, social
support (instrumental and emotional social support), and 6 strategies to cope with HIV
infection. Holding the other variables constant, “instrumental social support” was a
significant predictor of mental health pathology (OR = 0.65 P<0.001, 95% CI 0.52 - 0.81).
Using “avoidance of people” as a strategy to cope with HIV increased the odds of
depression almost threefold (OR = 2.79 P=0.006, 95% CI 1.34 - 5.82), “trying to keep it
from bothering” one reduced it by a factor two (OR = 0.45 P=0.068, 95% CI 0.20 - 1.06).
33% of patients were depressed indicating that depression is very common in patients on
ART in rural South Africa. In addition to drug treatment, interventions improving
instrumental social support and changes in the strategies to cope with HIV infection may be
effective in reducing this disease burden among ART patients.
Description
MSc (Med), Population-Based Field Epidemiology,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2009
Keywords
antiretrovirals, depression