Abstract
BackgroundStudies exploring HIV knowledge, attitudes and practices (KAP) of individuals with severe mental illness (SMI) have suggested their poorer knowledge about HIV. In KwaZulu-Natal (KZN) province, South Africa (SA), the epicentre of the country’s HIV epidemic, improving KAP is essential for reduce its incidence amongst individuals with SMI. Comparing the KAP related to HIV between those with SMI and chronic medical illnesses (CMI) such as hypertension and diabetes may expose gaps in KAP related to HIV in the mentally ill who are more vulnerable to HIV.AimThis study aimed to compare the KAP related to HIV between people living with SMI and CMI.SettingOutpatient clinics in Durban, SA.MethodsA cross-sectional structured questionnaire survey was conducted amongst 214 adult outpatients with SMI and CMI attending two general public sector hospitals in Durban, KZN. The KAP questionnaire consisted of three sections: general information, prevention and transmission of HIV.ResultsInterviews were conducted with 124 patients with SMI and 90 with CMI. Most were female (69.5%), single (57.5%) and unemployed (59.4%). The diagnosis of SMI was associated with poorer general information of HIV (p = 0.02), but not with its prevention and transmission compared with those with CMI. Educational level was associated with poorer performance in all three domains: general information of HIV (p = 0.01), prevention (p = 0.01) and transmission (p = 0.02) amongst all the participants.ConclusionGaps in the KAP of HIV amongst individuals with SMI compared with those with CMI suggested a need to provide focused health promotion regarding sexual health and HIV to the mentally ill at psychiatric facilities.
Highlights
IntroductionGlobal epidemiological studies have reported that people with severe mental illness (SMI) may be disproportionately affected by HIV.[1,2,3] This is of concern in South Africa (SA), which has the largest number of people infected with HIV worldwide, with KwaZulu-Natal (KZN) province having the highest incidence in the country.[4,5] Studies exploring HIV knowledge, attitudes and practices (KAP) of individuals with SMI have often pointed to the lack of knowledge about HIV transmission and risk prevention in this group of vulnerable individuals.[2,3,6]The mentally ill population is faced with numerous challenges, such as stigma, exploitation and unemployment.[7]
This study examined the knowledge, attitudes and practices of people living with severe mental illness (SMI) and compared them with those of people with chronic medical illnesses (CMI) such as hypertension, diabetes and asthma in the post antiretroviral era as both groups are regularly attending healthcare services but may receive different health education
Educational level was associated with poorer performance in all three domains, namely, general information of HIV (p = 0.01), transmission (p = 0.02) and prevention (p = 0.01) for both groups as a total (Table 4) and for knowledge on HIV transmission when the two groups were compared (Table 5)
Summary
Global epidemiological studies have reported that people with severe mental illness (SMI) may be disproportionately affected by HIV.[1,2,3] This is of concern in South Africa (SA), which has the largest number of people infected with HIV worldwide, with KwaZulu-Natal (KZN) province having the highest incidence in the country.[4,5] Studies exploring HIV knowledge, attitudes and practices (KAP) of individuals with SMI have often pointed to the lack of knowledge about HIV transmission and risk prevention in this group of vulnerable individuals.[2,3,6]The mentally ill population is faced with numerous challenges, such as stigma, exploitation and unemployment.[7]. Global epidemiological studies have reported that people with severe mental illness (SMI) may be disproportionately affected by HIV.[1,2,3] This is of concern in South Africa (SA), which has the largest number of people infected with HIV worldwide, with KwaZulu-Natal (KZN) province having the highest incidence in the country.[4,5] Studies exploring HIV knowledge, attitudes and practices (KAP) of individuals with SMI have often pointed to the lack of knowledge about HIV transmission and risk prevention in this group of vulnerable individuals.[2,3,6]. A South African study in Gauteng in 2011 reported that mentally ill patients had poor knowledge about many aspects of HIV and harboured several myths associated with its transmission.[9] The general perceptions of some black South Africans attributed HIV prevalence to witchcraft, http://www.sajpsychiatry.org. Comparing the KAP related to HIV between those with SMI and chronic medical illnesses (CMI) such as hypertension and diabetes may expose gaps in KAP related to HIV in the mentally ill who are more vulnerable to HIV
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