title: Determinants of common mental disorder, alcohol use disorder and cognitive morbidity among people coming for HIV testing in Goa, India.
abstract: OBJECTIVE
  To investigate associations between background characteristics (psychosocial adversity, risk behaviours/perception of risk and HIV-related knowledge, perceptions and beliefs) and psychological and cognitive morbidity among people coming for testing for HIV/AIDS in Goa, India.
  
  
  METHODS
  Analysis of cross-sectional baseline data (plus HIV status) from a prospective cohort study. Participants were recruited at the time of coming for HIV testing.
  
  
  RESULTS
  Consistent with associations found among general population samples, among our sample of 1934 participants, we found that indicators of psychosocial adversity were associated with CMD (common mental disorder - major depression, generalised anxiety and panic disorder) among people coming for testing for HIV. Similarly, perpetration of intimate partner violence was associated with AUD (alcohol use disorder). Two STI symptoms were associated with CMD, and sex with a non-primary partner was associated with AUD. Suboptimal knowledge about HIV transmission and prevention was associated with low cognitive test scores. In contrast with other studies, we found no evidence of any association between stigma and CMD. There was no evidence of modification of associations by HIV status.
  
  
  CONCLUSIONS
  Among people coming for testing for HIV/AIDS in Goa, India, we found that CMD occurred in the context of social and economic stressors (violence, symptoms of STI, poor education and food insecurity) and AUD was associated with violence and risky sexual behaviour. Further research is necessary to understand the role of gender, stigma and social norms in determining the relationship between sexual and mental health. Understanding associations between these background characteristics and psychological morbidity may help inform the design of appropriate early interventions for depression among people newly diagnosed HIV/AIDS.
authors.affiliation: Health Service & Population Research Department, Kings College London, London, UK.
authors.forename: Rosie
authors.initials: R
authors.lastname: Mayston
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
authors.forename: Melanie
authors.initials: M
authors.lastname: Abas
authors.forename: Priya
authors.initials: P
authors.lastname: Korgaonkar
authors.forename: Ramesh
authors.initials: R
authors.lastname: Paranjape
authors.forename: Savio
authors.initials: S
authors.lastname: Rodrigues
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000209:etiology; D003072:Cognition Disorders / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D057545:Social Stigma; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: HIV testing; Inde; India; alcohol; alcool; cognitive impairment; depresión; depression; deterioro cognitivo; dépistage du VIH; dépression; prueba del VIH; troubles cognitifs