Prevalence, types and associated factors of anxiety disorders among HIV positive patients attending Taso HIV Clinic, Mulago, Uganda

Abstract

Introduction. HIV/AIDS has been reported in all regions of the world with Sub-Saharan Africa being the worst affected. In Uganda, the prevalence of HIV infection is 6.4% for persons aged 15-49 years. Co-morbidity between HIV/AIDS and anxiety disorders is associated with poor social functioning and negative treatment outcomes. Early detection and treatment of the various anxiety disorders in HIV/AIDS may not only improve the quality of life of persons living with HIV/AIDs, but also result in substantial health benefits. Objective. This study aimed at determining the prevalence, types and associated factors of anxiety disorders among HIV positive patients attending TASO HIV clinic, Mulago, Uganda. Methods. This was a cross-sectional study in which a total of 334 adult HIV positive patients were recruited from the TASO HIV clinic, Mulago, using systematic random sampling technique. A socio-demographic questionnaire was administered. Health related information was collected from participants as well as from their clinic charts. The Self Report Questionnaire – 20 (SRQ-20) was used to determine global psychological distress (six or more of the 20 items of the SRQ-20) and significant anxiety symptomatology (five or more of the nine anxiety symptoms of the SRQ-20). For participants with SRQ scores of 6 and above, the Mini International Neuropsychiatric Interview version 5 plus, anxiety modules were used to diagnose the specific anxiety disorders. Data was analysed using SPSS. Chi square test and logistic regression were used at bivariate and multivariate analysis respectively. Results. Five point seven percent (5.7%) of participants had significant global psychological distress, while 4.7 % had significant anxiety symptomatology. Among those with significant global psychological distress (n=18), 83.3% (15) had at least one anxiety disorder. The most prevalent anxiety disorders were panic disorders and generalized anxiety disorders each at 27.8%. At univariate analysis, the factors that were significantly associated with having significant anxiety symptomatology were unemployment, poor quality of social support, duration of care of one year or less, and history of oral thrush. At multivariate analysis, the factors that were independently significantly associated with having significant anxiety symptomatology were poor quality of social support, unemployment, and history of oral thrush. Conclusion. Anxiety disorders contribute significantly to the psychiatric morbidity in HIV/AIDS in the Ugandan situation at TASO, Mulago Kampala. HIV/AIDS patients should be evaluated for anxiety disorders in the context of a comprehensive psychiatric assessment in order to further holistic HIV care.