Prevalence of Mental Health Disorders and Their Associated Risk Factors Among People Living with HIV in Rwanda: A Cross-Sectional Study.

Journal: AIDS and behavior

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Affiliated Institutions:  Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark. lauraomann@hotmail.com. Rwanda Biomedical Centre (RBC), Kigali, Rwanda. Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark. Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark. Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.

Abstract summary 

While life expectancy of people living with HIV is increasing, their burden of non-communicable diseases, including mental health disorders, is growing as well. The aim of this study is to investigate the prevalence and identify the risk factors associated with mental health disorders among this population in Rwanda. This cross-sectional study enrolled people living with HIV from 12 HIV clinics across Rwanda using random sampling. Trained HIV nurses conducted the Mini International Neuropsychiatric Interview to estimate the prevalence of major depressive episode, post-traumatic stress disorder, and generalized anxiety disorder. Sociodemographic, psychosocial, and HIV-related data were also collected. Associated risk factors for being diagnosed with one of the mental health disorders were assessed using modified Poisson regression with robust error variance. Of 428 participants, 70 (16.4%) had at least one mental health disorder with major depressive episode being most prevalent (n = 60, 14.0%). Almost all participants were adherent to antiretroviral therapy (n = 424, 99.1%) and virally suppressed (n = 412, 96.9%). Of those diagnosed with a mental health disorder, only few were aware of (n = 4, 5.7%) or under treatment for this mental health disorder (n = 5, 7.2%). Mental health disorders were associated with experiences of HIV-related stigma and discrimination (aRR = 2.14, 95%CI 1.30-3.53, p = 0.003). The results demonstrate underdiagnosis and undertreatment of mental health disorders among Rwandan People Living with HIV. Using HIV nurses to diagnose mental health disorders could serve as a low-cost strategy for integrating mental health care with existing HIV services and could inspire the implementation in other low-resource settings.

Authors & Co-authors:  Omann Laura Risbjerg LR Dushimiyimana Valentine V Musoni-Rwililiza Emmanuel E Arnbjerg Caroline Juhl CJ Niyonkuru Vivianne Umuhire VU Iyamuremye Jean Damascene JD Gasana Michel M Carlsson Jessica J Kallestrup Per P Kraef Christian C

Study Outcome 

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Statistics
Citations :  A. UNAIDS. Global factsheets 2021 HIV and AIDS estimates. https://aidsinfo.unaids.org . Accessed 27 Apr 2023.
Authors :  10
Identifiers
Doi : 10.1007/s10461-024-04358-3
SSN : 1573-3254
Study Population
Male,Female
Mesh Terms
Other Terms
Global health;Low- and middle-income countries;Mental health;People living with HIV;Sub-Saharan Africa
Study Design
Study Approach
Country of Study
Rwanda
Publication Country
United States