HIV/AIDS and mental health research in sub-Saharan Africa: a systematic review
Abstract
The relationship between mental illness and HIV/AIDS is complex and bidirectional. A significant amount of research has been performed in high-income countries but less is known about HIV and mental health in sub-Saharan Africa. The objectives of the review were to search the literature for quantitative studies conducted in sub-Saharan Africa on mental health and HIV and to critically evaluate and collate the studies in order to identify research needs and priorities. The databases Ovid, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI) were searched for variations of search terms related to HIV/AIDS and mental health and studies limited to the populations of African countries. In addition, we hand-searched indexes of key journals and the databases of academic theses. We included 104 papers or research publications. The majority of these were published after 2005. The major topics covered were: mental-health-related HIV-risk behaviour, HIV in psychiatric populations, and mental illness in HIV-positive populations. The reported prevalence levels of mental illness among people living with HIV or AIDS (PLHIV) was high, with all but one study noting a prevalence of 19% or higher. Neurocognitive changes in adults with HIV were also prevalent, with reported deficits of up to 99% in symptomatic PLHIV and 33% in non-symptomatic PLHIV. Research on HIV in relation to mental health is increasing; however, there is a need for good-quality prospective studies to investigate the bidirectional effects of mental illness and HIV on each other.
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People who have had prior contact with mental health services are less likely to receive cardiac catheterisations and coronary artery bypass grafting.
“For example, people who have had prior contact with mental health services are less likely to receive cardiac catheterisations and coronary artery bypass grafting, which in turn contributes to the higher mortality rates for circulatory disease observed in these populations.[116][117][118]”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [117]
The lower receipt of cardiac procedures contributes to higher mortality rates for circulatory disease in people with prior mental health service contact.
“which in turn contributes to the higher mortality rates for circulatory disease observed in these populations.[116][117][118]”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [117]
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Firth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30132-4 · Cited by 1,531 · see citing works
Agyepong, I. A., Sewankambo, N., Binagwaho, A., Coll-Seck, A. M., Corrah, T., Ezeh, A., Fekadu, A., Kilonzo, N., Lamptey, P., Masiye, F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31509-x · Cited by 245 · see citing works
Bhana, A., Rathod, S. D., Selohilwe, O., Kathree, T., & Petersen, I. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0503-0 · Cited by 197 · see citing works
Interventions and approaches to integrating HIV and mental health services: a systematic review
Chuah, F. L. H., Haldane, V. E., Cervero‐Liceras, F., Ong, S. E., Sigfrid, L., Murphy, G. A. V., Watt, N. F., Balabanova, D., Hogarth, S., Maimaris, W., et al. (2017) · Health Policy and Planning · doi:10.1093/heapol/czw169 · Cited by 160 · see citing works
“A previous systematic review revealed that the majority of HIV and AIDS and mental health studies in subSaharan Africa focused on mental health-related HIV risk behaviours, HIV in psychiatric populations, and mental illness in HIVpositive populations (Breuer et al. 2011).”
BackgroundChibanda, D., Benjamin, L. A., Weiss, H. A., & Abas, M. (2014) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000000258 · Cited by 154 · see citing works
Sherr, L., Cluver, L. D., Betancourt, T. S., Kellerman, S., Richter, L., & Desmond, C. (2014) · AIDS · doi:10.1097/qad.0000000000000327 · Cited by 143 · see citing works
“Psychological adjustment Conclusive evidence, now synthesized in several systematic reviews, demonstrates that parental HIV is associated with child psychological distress, such as depression, anxiety and post-traumatic stress [56–58].”
BackgroundCluver, L. D., Orkin, M. M., Boyes, M. E., Sherr, L., Makasi, D., & Nikelo, J. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.03.028 · Cited by 122 · see citing works
Depression in people living with HIV in sub‐Saharan Africa: time to act
Abas, M., Ali, G., Nakimuli‐Mpungu, E., & Chibanda, D. (2014) · Tropical Medicine & International Health · doi:10.1111/tmi.12382 · Cited by 119 · see citing works
“2013), but it is higher in people living with HIV (Owe-Larsson et al. 2009; Breuer et al. 2011).”
BackgroundWoollett, N., Cluver, L. D., Bandeira, M., & Brahmbhatt, H. (2017) · Journal of Child and Adolescent Mental Health · doi:10.2989/17280583.2017.1283320 · Cited by 112 · see citing works
“The HIV pandemic has increasingly brought attention to the unmet mental health needs of children and adolescents (Breuer et al., 2011), highlighting the necessity to integrate HIV and mental health care since positive mental health is critical in the management of HIV disease (Lowenthal et al.”
BackgroundInfluentialMacLean, J. R., & Wetherall, K. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.03.027 · Cited by 105 · see citing works
Sikkema, K. J., Dennis, A. C., Watt, M. H., Choi, K. W., Yemeke, T. T., & Joska, J. A. (2015) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2015.17 · Cited by 92 · see citing works
“Evidence from LMICs, though limited, has confirmed high rates of mental disorders and psychological distress among PLWH (Breuer et al. 2011; Chibanda et al. 2014).”
Chibanda, D., Cowan, F. M., Healy, J. L., Abas, M., & Lund, C. (2015) · Tropical Medicine & International Health · doi:10.1111/tmi.12500 · Cited by 87 · see citing works
“While no consensus exists on the most appropriate type of psychological interventions for CMD in PLWH in LMIC, a number of studies have reported on several approaches [2, 3, 34, 38, 60, 61], with a recent metaanalysis showing that treatment using psychological therapies, which largely consisted of CBT-based interventi…”
BackgroundEpidemiology of Dementia among the Elderly in Sub-Saharan Africa
Olayinka, O. O., & Mbuyi, N. (2014) · International Journal of Alzheimer's Disease · doi:10.1155/2014/195750 · Cited by 89 · see citing works
“Additionally, the relatively high prevalence of communicable diseases such as HIV-AIDS, low life expectancy at birth, the rising prevalence of cardiovascular risk factors such as hypertension and diabetes, and low-literacy level in SSA are important factors that are also reported to influence the epidemiology of chron…”
BackgroundSeth, P., Kidder, D. P., Pals, S. L., Parent, J., Mbatia, R., Chesang, K., Mbilinyi, D., Koech, E., Nkingwa, M., Katuta, F., et al. (2013) · Prevention Science · doi:10.1007/s11121-013-0420-8 · Cited by 76 · see citing works
“Estimates of depression among PLHIV in sub-Saharan Africa vary from 2 to 56 % (Antelman et al. 2007; Breur et al. 2011; Freeman et al. 2007; Kaharazu et al. 2006; Martinez et al. 2008; Marwick and Kaaya 2010; Monahan et al. 2008; Ramadhani et al. 2007), depending on the context and population studied.”
Casale, M. A. J., Wild, L. G., Cluver, L. D., & Kuo, C. (2014) · Journal of Behavioral Medicine · doi:10.1007/s10865-014-9556-7 · Cited by 70 · see citing works
“Many serious long-term medical illnesses, including HIV/AIDS, have been found to be a source of considerable stress and a key risk factor for poor mental health (Breuer et al. 2011; Catalan et al. 2011; Ciesla and Roberts 2001; Rodin and Voshart 1986; Sherr et al. 2011; WHO 2008).”
Degefa, M. T., Dubale, B. W., Bayouh, F. G., Ayele, B. A., & Zewde, Y. Z. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02850-3 · Cited by 63 · see citing works
Burgess, R. A., & Campbell, C. (2014) · Transcultural Psychiatry · doi:10.1177/1363461514526925 · Cited by 56 · see citing works
Zhu, Z., Hu, Y., Xing, W., Guo, M., Zhao, R., Han, S., & Wu, B. (2018) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2018.11.011 · Cited by 54 · see citing works
Tucker, J. D., Tso, L. S., Hall, B. J., Ma, Q., Beanland, R. L., Best, J., Li, H., Lackey, M. J., Marley, G., Rich, Z. C., et al. (2017) · EBioMedicine · doi:10.1016/j.ebiom.2017.01.036 · Cited by 53 · see citing works
“…co-morbidities has been noted among individuals livingwithHIV (Breuer et al., 2011; Catalan et al., 2011), although less is known about the burden of mental illness within low and middle-income contexts that have less developed mental health diagnostic and therapeutic systems (Breuer et al., 2011).”
BackgroundGaynes, B. N., Pence, B. W., Atashili, J., O’Donnell, J. K., NJAMNSHI, A. K., Tabenyang, M. E., Kefie, C., Whetten, R., Whetten, K., & Ndumbe, P. M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0140001 · Cited by 52 · see citing works
“Major Depressive Disorder (MDD) co-occurs frequently with HIV in sub-Saharan Africa, with most studies that use structured interviews reporting a prevalence ranging from 11–38%,[1] a figure roughly two to three times that found in comparable HIV-uninfected populations.”
BackgroundSlot, M., Sodemann, M., Gabel, C., Holmskov, J., Laursen, T. L., & Rodkjær, L. Ø. (2015) · HIV Medicine · doi:10.1111/hiv.12223 · Cited by 51 · see citing works
Roberts, K. J. S., Smith, C. J., Cluver, L. D., Toska, E., & Sherr, L. (2021) · AIDS and Behavior · doi:10.1007/s10461-020-03138-z · Cited by 46 · see citing works
Olashore, A. A., Paruk, S., Akanni, O. O., Tomita, A. M., & Chiliza, B. (2020) · AIDS and Behavior · doi:10.1007/s10461-020-03100-z · Cited by 45 · see citing works
Tsegaw, M., Andargie, G., Teklu, G. A., & Tareke, M. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.10.016 · Cited by 44 · see citing works
Casale, M. A. J., Wild, L. G., Cluver, L. D., & Kuo, C. (2013) · Psychology Health & Medicine · doi:10.1080/13548506.2013.832780 · Cited by 43 · see citing works
Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers
Murray, S. M., Familiar, I., Nakasujja, N., WINCH, P. J., Gallo, J. J., Opoka, R. O., Caesar, J., Boivin, M. J., & Bass, J. (2016) · AIDS Care · doi:10.1080/09540121.2016.1263722 · Cited by 42 · see citing works
Predictors of mental health problems in adolescents living with HIV in Namibia
Gentz, S. G., Calonge, I., Arias, R. M., & Ruiz‐Casares, M. (2017) · Child and Adolescent Mental Health · doi:10.1111/camh.12247 · Cited by 41 · see citing works
Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder
Roberts, K. J. S., Smith, C. J., Cluver, L. D., Toska, E., Zhou, S., Boyes, M. E., & Sherr, L. (2021) · AIDS and Behavior · doi:10.1007/s10461-021-03474-8 · Cited by 76 · see citing works
Kulisewa, K., Stockton, M. A., Hosseinipour, M. C., Gaynes, B. N., Mphonda, S., Udedi, M. M., & Pence, B. W. (2019) · AIDS and Behavior · doi:10.1007/s10461-019-02593-7 · Cited by 38 · see citing works
Breuer, E., Stoloff, K., Myer, L., Seedat, S., Stein, D. J., & Joska, J. A. (2014) · AIDS and Behavior · doi:10.1007/s10461-014-0698-y · Cited by 37 · see citing works
“The prevalence of common mental disorders (CMD) in people living with HIV/AIDS (PLWHA) is high [1] [2].”
Backgroundvan Rensburg, A. J., & Fourie, P. (2016) · International Journal of Mental Health Systems · doi:10.1186/s13033-016-0081-7 · Cited by 38 · see citing works
Cuadros, D., Tomita, A., Vandormael, A., Slotow, R., Burns, J., & Tanser, F. (2019) · Scientific Reports · doi:10.1038/s41598-018-37791-1 · Cited by 32 · see citing works
HIV-associated neurocognitive disorders at Moi teaching and referral hospital, Eldoret, Kenya
Mohamed, A. A., Oduor, C., & Kinyanjui, D. W. (2020) · BMC Neurology · doi:10.1186/s12883-020-01857-3 · Cited by 31 · see citing works
“The overall prevalence is also higher compared to published literature but so far MoCA is the best tool for assessing mild neurocognitive impairment in the absence of new validated HAND screening tools in Sub-Saharan Africa.”
ResultInfluentialNabunya, P., & Namuwonge, F. (2023) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01374-z · Cited by 31 · see citing works
Mental health research in Botswana: a semi-systematic scoping review
Opondo, P. R., Olashore, A. A., Molebatsi, K., Othieno, C. J., & Ayugi, J. O. (2020) · Journal of International Medical Research · doi:10.1177/0300060520966458 · Cited by 28 · see citing works
Nabunya, P., Namuwonge, F., Bahar, O. S., Ssentumbwe, V., Migadde, H., Mugisha, J., & Ssewamala, F. M. (2023) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2022.08.017 · Cited by 27 · see citing works
“Moreover, studies have documented the adverse impact of HIV-related stigma on the physical and psychosocial well-being of people living with HIV (PLHIV), including depression and post-traumatic stress disorders [12], loneliness and social isolation [13], and overall negative impact on their quality of life [14].”
Backgroundvan Coppenhagen, B., & Duvenage, H. S. (2019) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v25i0.1175 · Cited by 27 · see citing works
Casale, M. A. J. (2014) · British Journal of Health Psychology · doi:10.1111/bjhp.12127 · Cited by 26 · see citing works
Arat, G., & Wong, P. W. C. (2016) · International Journal of Mental Health Promotion · doi:10.1080/14623730.2016.1194305 · Cited by 26 · see citing works
Thurman, T. R., Kidman, R. C., & Taylor, T. M. (2014) · AIDS Care · doi:10.1080/09540121.2014.906555 · Cited by 23 · see citing works
HIV Risk Among Displaced Adolescent Girls in Ethiopia: the Role of Gender Attitudes and Self-Esteem
Bermudez, L. G., Yu, G., Lu, L. Z. N., Falb, K., Eoomkham, J., Abdella, G., & Stark, L. (2018) · Prevention Science · doi:10.1007/s11121-018-0902-9 · Cited by 22 · see citing works
Verhey, R., Chibanda, D., Vera, A., Manda, E., Brakarsh, J., & Seedat, S. (2019) · Transcultural Psychiatry · doi:10.1177/1363461519850337 · Cited by 21 · see citing works
Depression and social functioning among HIV-infected and uninfected persons in South Africa
Peltzer, K., Szrek, H., Ramlagan, S., Leite, R., & Chao, L. (2014) · AIDS Care · doi:10.1080/09540121.2014.946383 · Cited by 21 · see citing works
Haines, C., Loades, M. E., Coetzee, B., & Higson‐Sweeney, N. (2019) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2019-0037 · Cited by 20 · see citing works
Onu, D. U., Ifeagwazi, C. M., & Chukwuorji, J. C. (2020) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-020-09708-6 · Cited by 21 · see citing works
Mandlate, F. M., Greene, M. C., Pereira, L. F., Gouveia, M. L., Mari, J. D. J., Cournos, F., Duarte, C. S., Oquendo, M. A., Mello, M. F., & Wainberg, M. L. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04782-0 · Cited by 19 · see citing works
Nabunya, P., Ssewamala, F. M., Bahar, O. S., Michalopoulos, L. T. M., Mugisha, J., Neilands, T. B., Trani, J.-F., & McKay, M. M. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01055-7 · Cited by 18 · see citing works
“Abbreviations ART : Antiretroviral therapy; CLWH: Children living with HIV; CSQ: Client Satisfaction Questionnaire; DSMB: Data and Safety Monitoring Board; DSMP: Data Safety and Monitoring Plan; G‑CBT: Group Cognitive Behavioral Therapy; HIV: Human Immunodeficiency Viruses; ICHAD: International Center for Child Health…”
BackgroundMilanini, B., Allen, I. E., Paul, R. H., Bahemana, E., Kiweewa, F., Nambuya, A., Maswai, J. K., Langat, R., Owuoth, J., Martin, S., et al. (2020) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002242 · Cited by 18 · see citing works
Psychological disorders among human immunodeficiency virus-infected adults in southern Nigeria.
Ofovwe, C. E., & Ofovwe, C. (2013) · PubMed · Cited by 17 · see citing works
Arat, G. (2016) · Global Social Welfare · doi:10.1007/s40609-016-0046-4 · Cited by 17 · see citing works
“…or child-headed families (Wusu and Isiugo-Abanihe 2006), orphaned children (Olley 2008), child marriages (Jensen and Thornton 2003), HIV/AIDS (Breuer et al. 2011), unsupportive parents (Khasakhala et al. 2012), lower attachment to parents (Okello et al. 2014), corporal punishment (Omigbodun…”
BackgroundInfluentialSupport groups for HIV-positive people in South Africa: Who joins, who does not, and why?
Dageid, W. (2014) · African Journal of AIDS Research · doi:10.2989/16085906.2014.886601 · Cited by 15 · see citing works
“While there is need to strengthen services at a tertiary level, particularly for severe cases of physical and mental disorder, treatment in community and primary health care settings has the potential to reach more people faster and is thus of great importance (Breuer et al. 2011).”
BackgroundThe emotional wellbeing of lay HIV counselling and testing counsellors
Visser, M. J., & Mabota, P. M. (2015) · African Journal of AIDS Research · doi:10.2989/16085906.2015.1040812 · Cited by 15 · see citing works
“5% of the counsellors indicated that they were HIV-positive, which could affect their emotional wellbeing/mental health (Breuer et al., 2011).”
BackgroundZhong, H., Arjmand, I. K., Brandeau, M. L., & Bendavid, E. (2020) · AIDS Care · doi:10.1080/09540121.2020.1719966 · Cited by 14 · see citing works
Risk factors for poor mental health among adolescent mothers in South Africa
Roberts, K. J. S., Smith, C. J., Toska, E., Cluver, L. D., Haag, K., Wittesaele, C., Langwenya, N., Jochim, J., Saal, W., Shenderovich, Y., et al. (2022) · Psychology Health & Medicine · doi:10.1080/13548506.2022.2124295 · Cited by 14 · see citing works
“Given that both pregnancy and living with HIV have been found to be independently associated with poor mental health among adolescents (Breuer et al., 2011; Corcoran, 2016; Siegel & Brandon, 2014), experiencing the syndemic of both adolescent pregnancy and living with HIV may compound poor mental…”
BackgroundVisser, M. J., Hecker, H. E., & Jordaan, J. C. (2018) · AIDS Care · doi:10.1080/09540121.2017.1417530 · Cited by 14 · see citing works
Marcus, R., de Groot, A., Bachman, S. S., Chisolm, N., Quadri, Y., Cabral, H., & Rajabiun, S. (2018) · American Journal of Public Health · doi:10.2105/ajph.2018.304772 · Cited by 13 · see citing works
Occupational justice and social inclusion in mental illness and HIV: a scoping review protocol
Nhunzvi, C., Langhaug, L. F., Mavindidze, E., Harding, R., & Galvaan, R. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-024049 · Cited by 13 · see citing works
“2 This is especially so in contexts where the prevalence of HIV among people with mental illness is as high as 25% in sub-Saharan Africa.(3) 4 Disability-adjusted life years (DALYs) due to comorbid neuropsychiatric conditions and HIV is rising, with 80% of DALYs in sub-Saharan Africa being a result of the combined eff…”
Backgrounddos Santos, M., & Wolvaardt, G. G. (2016) · African Journal of AIDS Research · doi:10.2989/16085906.2016.1229683 · Cited by 13 · see citing works
Nhunzvi, C., Langhaug, L. F., Mavindidze, E., Harding, R., & Galvaan, R. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-036916 · Cited by 12 · see citing works
Abiodun, O. A., Lawal, I. A., & Omokanye, C. O. (2018) · AIDS Care · doi:10.1080/09540121.2018.1441973 · Cited by 11 · see citing works
“Others factors include substance abuse, poverty, social exclusion, conflicts and their consequences (Breuer et al., 2011).”
BackgroundInfluentialNurses’ implementation of mental health screening among HIV infected guidelines
Modula, M. J., & Ramukumba, M. M. (2018) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2018.02.001 · Cited by 11 · see citing works
Mugisha, J., Kinyanda, E., Osafo, J., Nalukenge, W., & Knizek, B. L. (2020) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-020-00332-8 · Cited by 11 · see citing works
Chhagan, U., Ntlantsana, V., Tomita, A. M., Naidu, T., Chiliza, B., & Paruk, S. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046593 · Cited by 11 · see citing works
Epidemiology of Psychopathology in HIV
Wainberg, M. L., McKinnon, K. M., & Cournos, F. (2014) · Wiley eBooks · doi:10.1002/9781118339503.ch1 · Cited by 11 · see citing works
Gamassa, E., Steven, E., Mtei, R. J., & Kaaya, S. (2023) · Research Square · doi:10.21203/rs.3.rs-2534893/v1 · Cited by 11 · see citing works
“HIV infection has an adverse effect on the mental health of an individual due to the direct effect to the brain causing neurocognitive changes as well as the indirect effects of the psychological distress of living with a chronic illness that impacts self-care practices (3).”
BackgroundMwase, C., Nkhoma, K. B., & Allsop, M. J. (2022) · Digital Health · doi:10.1177/20552076221133707 · Cited by 9 · see citing works
“68 This review found that the use of digital health psychosocial interventions among PLWH occurred in both community and clinical settings, suggesting their potential appropriateness across different models of palliative care in SSA (i.e. community, district and specialist).”
BackgroundIntervention targets for people living with HIV and depressive symptoms in Botswana
Vavani, B., Kraaij, V., Spinhoven, P., Amone‐P’Olak, K., & Garnefski, N. (2020) · African Journal of AIDS Research · doi:10.2989/16085906.2020.1727933 · Cited by 9 · see citing works
“From other countries we already know that depression among PLWH can be an important predictor of treatment failure, poor quality of life, disease progression and at worst mortality (Marwick & Kaaya, 2010; Breuer et al., 2011; Lewis et al., 2012; Abas et al., 2014; Sikkema et al., 2015).”
BackgroundBantjes, J. R., Kagee, A., & Saal, W. (2019) · AIDS and Behavior · doi:10.1007/s10461-019-02524-6 · Cited by 8 · see citing works
Rodkjær, L. Ø., Gabel, C., Laursen, T. L., Slot, M., Leutscher, P. D. C., Christensen, N. B., Holmskov, J., & Sodemann, M. (2016) · HIV Medicine · doi:10.1111/hiv.12381 · Cited by 8 · see citing works
World Mental Health Day 2023: We must leave no one behind in the response to HIV and mental health
Wainberg, M. L., Wolvaardt, G. G., Gouveia, L., & Ferenchick, E. K. (2023) · Journal of the International AIDS Society · doi:10.1002/jia2.26183 · Cited by 7 · see citing works
Asare, K., Tomita, A. M., Garrett, N., Slotow, R., Burns, J. K., Tanser, F. C., & Cuadros, D. F. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100433 · Cited by 7 · see citing works
Chukwuorji, J. C., Ezeonu, N. A., Ude, N., Itanyi, I. U., Eboreime, E., Kung, J. Y. C., Dennett, L., Olawepo, J. O., Iheanacho, T., Ogidi, A. G., et al. (2023) · AIDS Care · doi:10.1080/09540121.2023.2176428 · Cited by 7 · see citing works
“There is consistent evidence of greater Mental, Neurological and Substance use (MNS) disorders among people living with HIV (PLWH) as compared with the general population in low-and middle-income countries (LMIC) including sub-Saharan Africa (SSA) (Breuer et al., 2011; Chibanda et al., 2014).”
Six-Week Problem Area–Concordant vs 8-Week Problem Area–Discordant Group Interpersonal Psychotherapy
Kasujja, R., Birungi, P., Bhamidipati, K., Assefa, F. B., Kim, H., Peterson, K. M., Kohrt, B. A., & Bershteyn, A. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.5242 · Cited by 7 · see citing works
Rutakumwa, R., Tusiime, C., Mpango, R. S., Kyohangirwe, L., Kaleebu, P., Patel, V., & Kinyanda, E. (2023) · Psychiatry Journal · doi:10.1155/2023/1986908 · Cited by 5 · see citing works
Orphanhood and fertility in young adults: Evidence from South Africa
Bozzoli, C. G. (2016) · Economics & Human Biology · doi:10.1016/j.ehb.2016.05.002 · Cited by 5 · see citing works
“Stigmatization may also appear and create extreme distress (Vanable et al., 2006; Breuer et al., 2011; Sherr and Mueller, 2008; Sherr et al., 2008).”
BackgroundTomlinson, M., Hunt, X., & Skeen, S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-815063-4.00005-8 · Cited by 5 · see citing works
From businesswoman to banana vendor
Raja, S. K., Aggarwal, S., Raman, K. R., Minteer, W. B., Lieber, M., Patel, P. A., Bernstein, M. E., Farfel, A. O., Fenning, R. T. H., & Diamond, C. A. (2016) · AIDS · doi:10.1097/qad.0000000000001246 · Cited by 4 · see citing works
“health in sub-Saharan Africa [25], more research and investment in this area is needed to improve health outcomes in developing nations.”
BackgroundWoollett, N., Brahmbhatt, H., Dodd, K., Booth, M., Berman, H., & Cluver, L. D. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.04.021 · Cited by 4 · see citing works
“The HIV pandemic has increasingly brought attention to the unmet mental health needs of children and adolescents (Breuer et al, 2011), highlighting the comorbidity of HIV and mental health problems especially among those perinatally infected (Mellins & Malee, 2013; Lowenthal et al, 2014; Sherr et…”
Backgroundvan Wyk, E. S., & Kagee, A. (2023) · AIDS and Behavior · doi:10.1007/s10461-022-03955-4 · Cited by 4 · see citing works
“A systematic review of 104 sub-Saharan studies reported that the prevalence levels of post-traumatic stress disorder, anxiety, depression, and substance use disorder among adults living with HIV/AIDS was between 19% and 40% [6].”
BackgroundStockton, R. A., Paul, T., Voils-Levenda, A. C., Robbins, M., Li, P., & Zaitsoff, A. (2015) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-014-9233-0 · Cited by 4 · see citing works
“However, there is a paucity of research on HIV/ AIDS-related mental disorders in sub-Saharan Africa, and even less regarding HIV/AIDSrelated mental health counseling (Breuer et al. 2011; Freeman 2003).”
BackgroundInfluentialMunsami, A., Dreyer, A. J., Sibeko, G., Gouse, H., Nightingale, S., & Joska, J. A. (2022) · AIDS Care · doi:10.1080/09540121.2022.2099512 · Cited by 3 · see citing works
“Research suggests a complicated, bi-directional relationship, specifically between mental illness and HIV, due to possible direct brain effects and indirect secondary effects of HIV (Breuer et al., 2011).”
BackgroundSheira, L. A., Ryan, K. P., Fahey, C. A., Katabaro, E. D., Sabasaba, A. N., Njau, P. F., & McCoy, S. I. (2023) · AIDS Care · doi:10.1080/09540121.2023.2222576 · Cited by 3 · see citing works
“…the majority of studies, roughly 20% of PLHIV su ff ered from mental illnesses such as depression and anxiety (Breuer et al., 2011), with the prevalence of mental illness ranging from 19% to 32% among PLHIV globally (Breuer et al., 2011; Gill et al., 2020; Niu et al., 2016; Shadloo et al., 2018).”
BackgroundHealthy MindsPsychosocial Interventions for School-aged Children Affected by HIV/AIDS
Cluver, L. D., Kganakga, M., Boyes, M. E., & Park, M. (2012) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199765126.003.0006 · Cited by 3 · see citing works
Reproductive and sexual health concerns in HIV-positive youth, aged 15 to 24 years
Asadi, L., Saeieh, S. E., Koochak, H. E., Zareiyan, A., Khorsandi, B., & Moghadam, Z. B. (2023) · HIV & AIDS Review · doi:10.5114/hivar.2023.127710 · Cited by 2 · see citing works
“In a cohort study among HIV-positive 13-24-year-old individuals, a high-rate of mental disorders was determined in sub-Saharan Africa, where the average prevalence of depression was higher in HIV-positive people than in the general population [25, 26].”
BackgroundVavani, B., Kraaij, V., Spinhoven, P., & Garnefski, N. (2019) · Trials · doi:10.1186/s13063-019-3584-0 · Cited by 2 · see citing works
Skogen, V., Langseth, R., Rohde, G. E., Rysstad, O., Sørlie, T., & Lie, B. (2023) · AIDS Care · doi:10.1080/09540121.2023.2275043 · Cited by 2 · see citing works
“A systematic review of mental illness among PLHIV residing in sub-Saharan Africa showed high prevalence levels; all but one study cited in this review noted a prevalence of 19% or higher (Breuer et al., 2011).”
BackgroundAboobaker, A., Zingela, Z., & Adeniyi, O. V. (2022) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v28i0.1753 · Cited by 2 · see citing works
Psychiatric Comorbidities in HIV Infection
Thames, A. D., & Jones, J. D. (2017) · Springer eBooks · doi:10.1007/978-1-4939-7290-6_12 · Cited by 1 · see citing works
The impact of financial incentives on mental health among adults in HIV care in Lake Zone, Tanzania
Chitle, P., Sheira, L. A., Katabaro, E., Winters, S., Njau, P. F., Sabasaba, A. N., & McCoy, S. I. (2024) · AIDS · doi:10.1097/qad.0000000000003948 · Cited by 1 · see citing works
Kendall, S., Courtney, W. M., Sara, A., & N, M. S. (2015) · International Journal of Psychology and Counselling · doi:10.5897/ijpc2015.0310 · Cited by 1 · see citing works
HIV/AIDS in Kenyan schools: Neuropsychological and psychoeducational implications
Gabbidon, K., Chenneville, T., & Adeli, S. (2020) · International Journal of School & Educational Psychology · doi:10.1080/21683603.2020.1796122 · Cited by 1 · see citing works
Future Opportunities and Tools for Emerging Challenges for HIV/AIDS Control
Okware, S. (2022) · Infectious diseases · doi:10.5772/intechopen.100820 · Cited by 1 · see citing works
Chhagan, U., Ntlantsana, V., Karim, E., Thela, L. T., Tomita, A. M., Chiliza, B., & Paruk, S. (2024) · Early Intervention in Psychiatry · doi:10.1111/eip.13561 · Cited by 1 · see citing works
“Studies have also reported the prevalence of cognitive deficits ranging from 4% in the Democratic Republic of Congo to 99% in a Nigerian sample of PWH (Breuer et al., 2011).”
Mental disorders and adherence to antiretroviral treatment in health facilities in MozambiquePreprint
Mandlate, F. M., Greene, M. C., Pereira, L. F., Gouveia, M. L., Mari, J. D. J., Cournos, F., Duarte, C. S., Oquendo, M. A., Mello, M. F., & Wainberg, M. L. (2022) · medRxiv · doi:10.1101/2022.07.17.22277384 · Cited by 1 · see citing works
Jedlinski, S. J. (2015) · UpSpace Institutional Repository (University of Pretoria)
CO-MORBIDITY OF HIV/AIDS AND MENTAL ILLNESS
Mavundla, T. R. (2015) · Africa Journal of Nursing and Midwifery · doi:10.25159/2520-5293/804
Common mental and substance use disorders among people seeking HIV testing
Saal, W. (2017) · SUNScholar (Stellenbosch University)
Lessons from Research Innovations in Depression and HIV in Low- and Middle-Income Countries
Jopling, R., Yang, J. P., Meffert, S. M., Müller, M., Nyamayaro, P. C., & Abas, M. (2019) · Springer eBooks · doi:10.1007/978-3-319-70134-9_6-1
Vazi, T. (2014) · Nelson Mandela University Research Repository
Chibanda, D. (2016) · Open University of Cape Town (University of Cape Town)
- Authors
- Breuer, E., Myer, L., Struthers, H., & Joska, J. A.
- Affiliations
- University of Cape Town (ZA)
- Anova Health Institute (ZA)
- Groote Schuur Hospital (ZA)
- Venue
- African Journal of AIDS Research
- Published
- 2011-06
- Volume
- 10
- Issue
- 2
- Pages
- 101-122
- ISSN
- 1608-5906 (ISSN-L)
- 1727-9445
- OpenAlex
- W2094957198
- Cited by
- 112
- References
- 166
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 11 · 2022: 10 · 2021: 5 · 2020: 15 · 2019: 11 · 2018: 6 · 2017: 8 · 2016: 10 · 2015: 10 · 2014: 13 · 2013: 4 · 2012: 2
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- African Journal of AIDS Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- United States Agency for International Development
- U.S. President’s Emergency Plan for AIDS Relief
- Anova Health Institute
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › HIV/AIDS Impact and Responses
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- HIV/AIDS, mental health, sub-Saharan Africa, people living with HIV, prevalence of mental disorders, HIV risk behavior, psychiatric populations, neurocognitive impairment, research priorities
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