title: Socio-demographic correlates of depression and anxiety among female caregivers living with HIV in rural Uganda.
abstract: Women living with HIV are at increased risk for psychosocial distress, especially among social and economically disadvantaged women living in rural areas. Little is known about how social support and wealth impacts the mental health of women caring for young children in low- and middle-income countries. The purpose of this paper was to assess demographic, socio-economic, and social support correlates of depression and anxiety in HIV-infected+ female caregivers living in rural Uganda. Depression and anxiety were assessed using the Hopkins Symptom Checklist (HSCL-25), two-domains of social support (family and community) were measured with the adapted Multidimensional Scale for Perceived Social Support, and wealth was measured using a checklist of material possessions and housing quality among 288 women. Multivariable linear regression models assessed the association of depression and anxiety with demographic and social predictors. Sixty-one percent of women reported clinically significant symptoms of depression or anxiety using the standard HSCL-25 cut-off of >1.75. Lower wealth (p = .01) and family support (p = .01) were significantly associated with more depressive symptoms, with greater family support being more protective of depression in the highest wealth group (top 20%) compared to the lowest. More anxiety symptoms were associated with lower wealth (p = .001), lower family support (p = .02), and higher community support (p = .003). Economic and social support factors are important predictors of caregiver mental health in the face of HIV disease in rural Uganda. Findings suggest that interventions should consider ways to increase economic opportunities and strengthen family support for HIV+ caregivers.
authors.affiliation: a Department of Psychiatry , Michigan State University , East Lansing , MI , USA.
authors.forename: Itziar
authors.initials: I
authors.lastname: Familiar
authors.affiliation: b Mental Health Department , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Murray
authors.affiliation: a Department of Psychiatry , Michigan State University , East Lansing , MI , USA.
authors.forename: Horacio
authors.initials: H
authors.lastname: Ruisenor-Escudero
authors.affiliation: c Department of Statistics and Probability , Michigan State University , East Lansing , MI , USA.
authors.forename: Alla
authors.initials: A
authors.lastname: Sikorskii
authors.affiliation: d Department of Psychiatry , College of Health Sciences, Makerere University , Kampala , Uganda.
authors.forename: Noeline
authors.initials: N
authors.lastname: Nakasujja
authors.affiliation: a Department of Psychiatry , Michigan State University , East Lansing , MI , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Boivin
authors.affiliation: e Department of Pediatrics and Child Health , College of Health Sciences, Makerere University , PO Box 7072, Kampala , Uganda.
authors.forename: Robert
authors.initials: R
authors.lastname: Opoka
authors.affiliation: b Mental Health Department , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Bass
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology*; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D012424:Rural Population; D012923:Social Class; D012944:Social Support; D014454:Uganda; D055815:Young Adult
keywords: HIV/AIDS; Uganda; anxiety; caregivers; depression