RESUMO
BACKGROUND: Psychiatric morbidity is commonly associated with HIV disease and may have adverse effects. This aspect may be overlooked at comprehensive HIV care centers in Low and Middle-Income Countries. OBJECTIVES: The aim of this study was to determine the prevalence of undetected psychiatric morbidity among HIV/AIDS adult patients attending Comprehensive Care Centre in a semi-urban clinic, in Nairobi, Kenya. DESIGN: Descriptive cross-sectional study of adult HIV patients not receiving any psychiatric treatment was conducted. PARTICIPANTS/METHODS: The participants consisted of consecutive sample of adults (n = 245) attending HIV Comprehensive Care Clinic at Kangemi Health Centre, Nairobi. The Mini International Neuropsychiatric Interview (MINI) was administered to screen for undetected psychiatric morbidity. Socio-demographic characteristics were recorded in a questionnaire. Sample descriptive analysis was performed and prevalence of undetected psychiatric morbidity calculated. Chi-square test for independence was used to examine the associations between patient characteristics and undetected morbidity. Multivariable logistic regression analysis was performed to determine independent predictors of undetected psychiatric morbidity. RESULTS: The mean age of our participants was 37.3 years (SD 9.2) Three-quarters (75.9%) of participants were females and median duration of HIV illness was 5 years. The prevalence of (previously undetected) psychiatric morbidity was 71.4% (95% CI 65.3-77). The leading psychiatric disorders were MDD (32.2%), PTSD (18.4%), Dysthymia (17.6%), and OCD (17.6%). Overall psychiatric morbidity was associated with low income (
RESUMO
Background: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a great challenge among young people in Kenya. Young people living with HIV are faced with a lot of challenges that are often overlooked and may have an impact on their treatment adherence and overall well-being. This calls for interventions that are age-appropriate and which tap into the psychosocial problems they experience. This is a protocol of a proposed study aimed at developing a facilitator-led peer support manual called the "Positive and Healthy Living Program" that will be the basis for running support groups with young people at the Comprehensive Care Center (CCC) at the Kenyatta National Hospital (KNH). Methods: We will carry out our study in two phases. The first phase will focus on the development of the manual and training of peer-facilitators. The second phase will make use of a pilot trial research design using both qualitative and quantitative approaches. It will be carried out among 10-24 year-olds attending CCC at KNH, and will consist of three groups: Tumaini Group (10-14 years), Amani Group (15-19 years), and Hodari Group (20-24 years). The groups will participate in an eight-session support group, whose activities will focus on four domains: social-recreation, psychotherapy, peer-modeling, and psychoeducation. Quantitative data will be collected using laboratory measures of Viral Load and CD4 as well as socio-psychological assessment tools. Qualitative data will be collected through interviews with the young people and peer facilitators. We will conduct a descriptive analysis which will describe the key features of the dataset and bivariate analyses will examine the association between variables. The change will be measured at baseline and post-treatment. The interviews will be coded into themes and we will generate experiential categories from the data around the effectiveness of the program, the peer facilitators' experience of providing support, how the young people respond to the program, and its influence on their overall well-being. Discussion: We expect that the peer facilitators will find this manualized treatment acceptable and the eight-sessions group intervention will be feasible for the three age groups. We hypothesize that there will be improvements detected with regards to reported adherence and viral load, self-esteem, depression, and psychological functioning.