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J Affect Disord. 2015 Mar 15;174:619-26. doi: 10.1016/j.jad.2014.12.017. Epub 2014 Dec 13.

HIV, violence and women: unmet mental health care needs.

Author information

1
School of Nursing, University of California, San Francisco, CA, USA.
2
Department of Social and Behavioral Sciences, University of California, San Francisco, CA, USA.
3
Department of Psychiatry, University of California, San Francisco, CA, USA.
4
Kenya Medical Research Institute, Department of Obstetrics and Gynecology, University of Nairobi, Kenya; Family AIDS Care Education & Services, Kenya.
5
Family AIDS Care Education & Services, Kenya.
6
Family AIDS Care Education & Services, Kenya; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, USA.
7
Department of Psychiatry, University of California, San Francisco, CA, USA. Electronic address: Susan.Meffert@ucsf.edu.

Abstract

BACKGROUND:

HIV-infected (HIV+) women have high rates of Gender Based Violence (GBV). Studies of GBV find that approximately 50-90% of survivors develop mood and anxiety disorders. Given that women in sub-Saharan African constitute the largest population of HIV+ individuals in the world and the region׳s high GBV prevalence, mental health research with HIV+ women affected by GBV (HIV+GBV+) in this region is urgently needed.

METHODS:

Qualitative methods were used to evaluate the mental health care needs of HIV+GBV+ female patients at an HIV clinic in the Kisumu County, Kenya. Thirty in-depth interviews and four focus groups were conducted with patients, healthcare providers and community leaders. Interviews were transcribed, translated and analyzed using qualitative data software.

RESULTS:

Respondents stated that physical, sexual and emotional violence against HIV+ women was widely prevalent and perpetrated primarily by untested husbands accusing a wife of marital infidelity following her positive HIV test result. Mental health problems among HIV+GBV+ women included depressive, anxiety, traumatic stress symptoms and suicidal thoughts. Participants opined that emotional distress from GBV not only caused HIV treatment default, but also led to poor HIV health even if adherent. Respondents agreed that mental health treatment was needed for HIV+GBV+ women; most agreed that the best treatment modality was individual counseling delivered weekly at the HIV clinic.

LIMITATIONS:

Emotional distress may be higher and/or more varied among HIV+GBV+ women who are not engaged in HIV care.

CONCLUSIONS:

Mental health care is needed and desired by HIV+GBV+ women in Kisumu County, Kenya.

KEYWORDS:

Depression; Domestic violence; Gender-Based Violence; Global health; HIV; Posttraumatic Stress Disorder

PMID:
25574781
PMCID:
PMC4340747
DOI:
10.1016/j.jad.2014.12.017
[Indexed for MEDLINE]
Free PMC Article

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