Abstract
With the advent of advanced antiretroviral therapy, HIV is no longer perceived as a serious
illness, but a manageable one. However, many unrelated problems arise that limit the
quality of life of people livi ng with HIV, such as mental illness which can make it difficult to
diagnose, seek help, receive quality care, influence outcomes, and adhere to treatment.
Unfortunately, more than half of the HIV positive population that suffer from mental
illnesses have not received an official diagnosis of their conditions and remain undertreated
due to lack of regular screening and integrated services in most of developing
countries like Lesotho. The purpose of this study was to establish the prevalence of mental
health illnesses and describe the socio-demographic and clinical characteristics in adults
with HIV attending Molhomi hospital in Maseru, the capital of Lesotho.
Methodology
The researcher conducted a retrospective data analysis. The population of this study
included all adult HIV patients (at least 18 years) who attended Mohlomi Hospital between
01 January 2020 and 31 December 2022. The sample size was determined at 95%
confidence level by using the Miller and Brewer’s formula. Participants for this study were
selected from Molhomi Hospital’s database keeping patients’ medical records using a
systematic sampling technique. Sociodemographic and clinical characteristics data were
collected and analyzed using SPSS. The researcher used categorical variables in
statistical analysis. A bivariate logistic regression analysis using correlation was conducted
to assess the association between mental illness (outcome variable) which was binary and
socio-demographic and clinical factors (explainable variables). All the explainable
variables associated with the outcome variable were combined in multivariate analysis to
control for confounding factors. A p-value of <0.05 was intended as a significant
relationship with 95% confidence level. A p-value of less than 0.05 was deemed indicative
of a significant relationship, corresponding to a 95% confidence level.
ABSTRACT
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Results
The overall prevalence of the mental illness in adults’ HIV patients who attended Mohlomi
hospital between 01 January 2020 and 31 December 2022 was recorded at 70.1%;
The results of this study indicate higher prevalence of mental illness in individuals aged
between 31 and 45 years with 44.6%. The mean participant’s age was 40.41 years (SD =
12.765), the minimum age was 18 and the maximum 77 years; more than half participants
were female (n=107, 68.2%); majority were married (n=87, 55.4%); most of the
participants attained secondary level education (42.7%); majority were catholic (39.5%);
depression emerged as the prevalent diagnosis, impacting 42% (n=66). This was followed
by psychosis (n=59, 37.6%), drug/substance disorder (n=14, 8.9%), both PTSD and GAD,
each at 1.9% (n=3); 10.8% of participants were hospitalised;19 (12.1 %) had marital
conflicts; 5.1 % had financial constraints; majority of participants were unemployed (n=85,
54.1%); 10.8 % had history of mental illness in the family; 2.5% were psychotropic
treatment defaulters; 10.2% were drinking alcohol; 5.8% were smoking cigarettes and
9.5% were using illegal drugs; psychotropic medication was the most prevalent type of
intervention delivered (n=125, 79.6%), followed by psychosocial therapy (n=29, 18.5%)
and psychological intervention (n=3, 1,9%). The bivariate analysis indicated that having
substance misuse habit was associated with the occurrence of mental disorder, the
correlation was statically significant. While the multivariate analysis revealed that all the
explainable variables were predictable factors of mental illness in the population at the α
level (p˂.005).
Conclusion
The highest prevalence of mental illness was observed among adults living with HIV/AIDs
in this research study which was comparable to the prevalence of common mental
disorders in Ethiopia and higher than other studies in sub-Saharan Africa, European,
American and Asiatic Countries.
Mental health disorders contribute to the burden of diseases globally. In people living with
HIV, untreated mental illnesses are associated with increased HIV/AIDs morbidity and
mortality due to poor drug adherence, failure to access HIV care and treatment. Therefore,
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addressing the mental health issues is very key to comprehensive client support factors
like poor support, poor disclosure, stigma and discrimination, receiving poor-quality health
services, lack of emotional support from family, friends, care providers and other factors
outlined as associated with greater mental health disorders’ morbidity. The startling
findings call for greater investment in public health strategies that are universal, targeted,
and indicated.