Original Research
Correlates and cascade of HIV care in patients with psychiatric disorders in the Eastern Cape province, South Africa
Submitted: 09 June 2021 | Published: 15 February 2022
About the author(s)
Adila Aboobaker, Department of Psychiatry and Behavioural Sciences, Faculty of Health Sciences, Walter Sisulu University, East London; Department of Psychiatry, Cecilia Makiwane Hospital, Mdanstane, East London, South AfricaZukiswa Zingela, Department of Psychiatry and Behavioural Sciences, Faculty of Health Sciences, Walter Sisulu University, Mthatha; Department of Psychiatry, Mthatha Hospital Complex, Mthatha, South Africa
Oladele V. Adeniyi, Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, East London; Department of Family Medicine, Cecilia Makiwane Hospital, East London, South Africa
Abstract
Background: The cascade of human immunodeficiency virus (HIV) care in patients with psychiatric disorders is poorly understood.
Aim: This study determined the prevalence of HIV and described its cascade of care among patients with psychiatric disorders in the Eastern Cape province, South Africa. The study also examined the correlates of HIV comorbidity with psychiatric disorders in the cohort.
Methods: In this cross-sectional study, a total of 368 individuals attending the Psychiatric Outpatients’ Department of Cecilia Makiwane Hospital in Eastern Cape were interviewed with a structured questionnaire. Relevant items on demographics and clinical information were extracted from the medical records. Virologic suppression was defined as viral load < 1000 RNA copies/mL.
Results: The HIV prevalence after the intervention was 18.8% and a significant proportion of participants already knew their status (n = 320; 87.0%). Linkage to care and antiretroviral therapy initiation occurred in 61 participants, of those diagnosed with HIV (88.4%), with 84.1% being eligible for viral load monitoring (n = 58) and 53.4% having achieved virologic suppression. Being female (AOR = 5.48; 95% CI 2.61–11.51) and black (adjusted odds ratio [AOR] = 3.85; 95% confidence interval [CI] 1.06–14.03) were independent predictors of HIV comorbidity in individuals living with psychiatric disorders.
Conclusion: This study found a moderately high prevalence (close to 19%) of HIV in individuals with psychiatric disorders, with a significant correlation with being female and being black people. This study also found a significant gap in the linkage to antiretroviral therapy (ART) initiation and a low rate of virologic suppression of 53.4%. Clinicians, therefore, should monitor and provide interventions for patients with concomitant HIV infection along this cascade of care.
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