258855 Injecting drug use, gender and home-based care: Factors associated with depression, anxiety and social support in people living with HIV in Northern Viet Nam

Tuesday, October 30, 2012

Kimberly Green, MA , Ghana Country Office, FHi 360, Accra, Ghana
Background: Although mental health and social support in people living with HIV (PLHIV) has been widely researched in developed countries, limited information exists in Asia - particularly among drug users and women.

Methods: A mixed-method longitudinal intervention controlled trial was conducted with 822 PLHIV (32% female) enrolled in two HIV out-patient clinics in northern Vietnam. The study included a double-baseline, two rounds of post-intervention data collection and embedded qualitative study. The Hopkins Symptom Checklist was used to identify clinical depression and anxiety and a modified Duke-UNC Social Support Scale measured inter-relational social support.

Results: 42% of participants suffered from depression: 53% female, 37% male; and 24.8% anxiety (32% female, 22% male). Women were at greater odds of experiencing depression (OR4.49;p<0.001) and anxiety (OR2.80;p=0.001), as were men engaged in injection drug use in the past six months (depression: OR2.97;p=0.001; anxiety: OR3.18;p=0.001). Social support scores were just below optimal levels; receiving home-based care services was associated with better support (p=0.037), depression with worse social support (p<0.001). Women who participated in qualitative interviews described spousal drug use, concerns about children's future, financial insecurity and physical ill-health as contributors to mental health and sub-optimal social support, while men cited lack of employment and children's future wellbeing as primary sources of worry.

Conclusions: There is significant unmet mental health need among PLHIV in this cohort. Data indicate the importance of integrating gender-sensitive mental health care and maintaining social support provided through home-based care services for drug using and non-drug using populations into routine HIV care.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Describe the mental health morbidity of people living with HIV (PLHIV) in two HIV clinics in northern Viet Nam Identify factors associated with depression and anxiety in PLHIV Discuss recommended interventions to improve detection and management of depression and anxiety in HIV out-patient clinics

Keywords: Mental Disorders, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in Asia and Africa for more than ten years on HIV prevention and care programs. My current interest is providing quality of care to people living with HIV and other chronic diseases including through the recognition and management of mental health disorders. I am the PI on the study to be presented at APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.