title: Prevalence and correlates of probable common mental disorders in a population with high prevalence of HIV in Zimbabwe.
abstract: BACKGROUND
  In 2014 close to 10 million people living with HIV (PLWH) in sub-Saharan Africa were on highly active anti-retroviral therapy (HAART). The incidence of non-communicable diseases has increased markedly in PLWH as mortality is reduced due to use of HAART. Common mental disorders (CMD) are highly prevalent in PLWH. We aimed to determine factors associated with probable CMD and depression, assessed by 2 locally validated screening tools in a population with high prevalence of HIV in Harare, Zimbabwe.
  
  
  METHODS
  We carried out a cross-sectional survey of a systematic random sample of patients utilizing the largest primary health care facility in Harare. Adults aged ≥18 years attending over a 2-week period were eligible, excluding those who were critically ill or unable to give written informed consent. Two locally validated screening tools the Shona symptom questionnaire (SSQ-14) and the Patient Health Questionnaire (PHQ-9) were administered by trained research assistants to identify probable CMD and depression.
  
  
  RESULTS
  Of the 264 participants, 165 (62.5 %) were PLWH, and 92 % of these were on HAART. The prevalence of probable CMD (SSQ14 > = 9) and depression (PHQ9 > = 11) were higher among people living with HIV than among those without HIV (67.9 and 68.5 % vs 51.4 and 47.2 % respectively). Multivariable analysis showed female gender and recent negative life events to be associated with probable CMD and depression among PLWH (gender: OR = 2.32 95 % CI:1.07-5.05; negative life events: OR = 4.14; 95 % CI 1.17-14.49) and with depression (gender: OR = 1.84 95 % CI:0.85-4.02; negative life events: OR = 4.93.; 95 % CI 1.31-18.50) CONCLUSION: Elevated scores on self-report measures for CMD and depression are highly prevalent in this high HIV prevalence population. There is need to integrate packages of care for CMD and depression in existing primary health care programs for HIV/AIDS.
authors.affiliation: University of Zimbabwe, College of Health Sciences, Mazowe Street, P.O Box A178, Harare, Zimbabwe. dichi@zol.co.zw.
authors.forename: Dixon
authors.initials: D
authors.lastname: Chibanda
authors.affiliation: University College London, Gower Street, London, WC1E6BT, UK.
authors.forename: Frances
authors.initials: F
authors.lastname: Cowan
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E7HT, UK.
authors.forename: Lorna
authors.initials: L
authors.lastname: Gibson
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E7HT, UK.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Alan J Flisher Center for Public Mental Health, Cape Town, South Africa.
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D015030:Zimbabwe / Q000453:epidemiology