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Current Psychiatry Research and Reviews

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ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

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Research Article

The Role of Depression, Anxiety and Illness Characteristics on Risky Sexual Behaviour among People Living with HIV in A Malaysian Tertiary Reference Hospital

Author(s): Seng Choi Chong*, Normala Ibrahim, Jin Kiat Ang, Ruziana Masiran, Kit-Aun Tan, Beatrice Ng Andrew, Kwong-Yan Soh and Suresh Kumar

Volume 15, Issue 4, 2019

Page: [267 - 276] Pages: 10

DOI: 10.2174/2666082215666191022112412

Price: $65

Abstract

Background: People living with HIV (PLHIV) have a longer lifespan with treatment and continue to be sexually active. To date, the extent of risky sexual behaviour among local PLHIV and its associated factors were undetermined.

Objective: To examine the role of depression, anxiety and illness characteristics on risky sexual behaviour among PLHIV attending care in a Malaysian tertiary reference hospital (N= 406).

Methods: It was a cross-sectional study. Subjects were recruited by systematic random sampling. Risky sexual behaviour was determined by using the modified National Youth Risk Behaviour Survey. PHQ-9 and GAD-7 were used to measure the depressive and anxiety symptoms, respectively. Chi-square test was used to examine the association between the variables. Multiple logistic regression was used to examine the predictors of the study. A p value of less than 0.05 was considered significant and odds ratio was used as the measure of risk association.

Results: Our study showed that 29.3% had risky sexual behaviour. Meanwhile, 21.9% and 26.4% had depressive and anxiety symptoms, respectively. Risky sexual behaviour was significantly associated with age, religion, education level, duration of HIV diagnosis, depressive and anxiety symptoms. From multivariate logistic regression, duration of HIV diagnosis and anxiety symptoms significantly predicted risky sexual behaviour.

Conclusion: This study highlights that a substantial number of PLHIV had risky sexual behaviour and psychological symptoms. It is important for psychological interventions that reduce risky sexual behaviour among PLHIV who attend treatment, especially during the early phase.

Keywords: Risky sexual behaviour, depression, anxiety, illness characteristic, people living with HIV, psychological interventions.

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[1]
UNAIDS. How AIDS changed everything: MDG 6: 15 years, 15 lessons of hope from the AIDS response. Availabale at: https://issuu.com/unaids/docs/mdg6report_no-annexes_en
[2]
Centers for Disease Control and Prevention. U.S. HIV and AIDS cases reported through December 2000. HIV AIDS Surveill Rep 2000; 12(2): 1-44.
[3]
UNAIDS. Report on the global AIDS epidemic. Geneva: UNAIDS 2010.
[4]
Olise P. Primary health care for sustainable development. Abuja: Ozege Publications 2007.
[5]
Crepaz N, Marks G. Towards an understanding of sexual risk behavior in people living with HIV: a review of social, psychological, and medical findings. AIDS 2002; 16(2): 135-49.
[http://dx.doi.org/10.1097/00002030-200201250-00002] [PMID: 11807297]
[6]
Kalicman SC. HIV transmission risk behaviours of men and women living with HIV-AIDS: Prevalence, predictors and emerging clinical interventions. Clin Psychol Sci Pract 2000; 7: 32-47.
[http://dx.doi.org/10.1093/clipsy.7.1.32]
[7]
Suleiman A, Ed. National strategic plan ending AIDS 2016-2030. Malaysia: Ministry of Health 2015.
[8]
Napper LE, Fisher DG, Reynolds GL, Johnson ME. HIV risk behavior self-report reliability at different recall periods. AIDS Behav 2010; 14(1): 152-61.
[http://dx.doi.org/10.1007/s10461-009-9575-5] [PMID: 19475504]
[9]
Simoni JM, Safren SA, Manhart LE, et al. Challenges in addressing depression in HIV research: assessment, cultural context, and methods. AIDS Behav 2011; 15(2): 376-88.
[http://dx.doi.org/10.1007/s10461-010-9836-3] [PMID: 21046221]
[10]
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16(9): 606-13.
[http://dx.doi.org/10.1046/j.1525-1497.2001.016009606.x] [PMID: 11556941]
[11]
Sherina MS, Arroll B, Goodyear-Smith F. Criterion validity of the PHQ-9 (Malay version) in a primary care clinic in Malaysia. Med J Malaysia 2012; 67(3): 309-15.
[PMID: 23082424]
[12]
Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166(10): 1092-7.
[http://dx.doi.org/10.1001/archinte.166.10.1092] [PMID: 16717171]
[13]
Kroenke K, Spitzer RL, Williams JBW, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 2007; 146(5): 317-25.
[http://dx.doi.org/10.7326/0003-4819-146-5-200703060-00004] [PMID: 17339617]
[14]
Sidik SM, Arroll B, Goodyear-Smith F. Validation of the GAD-7 (Malay version) among women attending a primary care clinic in Malaysia. J Prim Health Care 2012; 4(1): 5-11. 1.
[http://dx.doi.org/10.1071/HC12005] [PMID: 22377544]
[15]
Shacham E, Morgan JC, Önen NF, Taniguchi T, Overton ET. Screening anxiety in the HIV clinic. AIDS Behav 2012; 16(8): 2407-13.
[http://dx.doi.org/10.1007/s10461-012-0238-6] [PMID: 22718040]
[16]
Thanawuth N, Rojpibulstit M. Sexual risk behaviors among HIV-patients receiving antiretroviral therapy in Southern Thailand: roles of antiretroviral adherence and serostatus disclosure. AIDS Care 2016; 28(5): 612-9.
[http://dx.doi.org/10.1080/09540121.2015.1120856] [PMID: 26666292]
[17]
Kalichman SC, Cherry C, Kalichman MO, et al. HIV sexual transmission risks in the context of clinical care: a prospective study of behavioural correlates of HIV suppression in a community sample, Atlanta, GA, USA. J Int AIDS Soc 2015; 18: 19930.
[http://dx.doi.org/10.7448/IAS.18.1.19930] [PMID: 26249127]
[18]
Salaudeen AG, Musa OI, Ojotule A, Yusuf AS, Durowade KA, Omokanye LO. Condom use among people living with HIV/AIDS attending Abejukolo General Hospital in Kogi State, North Central Nigeria. Ann Afr Med 2014; 13(3): 99-103.
[http://dx.doi.org/10.4103/1596-3519.134378] [PMID: 24923368]
[19]
Metha KG, Rajendra KB, Sangita VP, Parag DC, Vihang SM. Assessment of sexual behaviour and serostatus disclosure among people living with HIV/AIDS attending antiretroviral therapy in tertiary care hospital, Baroda. J HIV Hum Reprod 2013; 1(2): 77-83.
[http://dx.doi.org/10.4103/2321-9157.126636]
[20]
Ncube NM, Akunna J, Babatunde F, et al. Sexual risk behaviour among HIV-positive persons in Kumasi, Ghana. Ghana Med J 2012; 46(1): 27-33.
[PMID: 22605886]
[21]
Outlaw AY, Naar-King S, Janisse H, Parsons JT. Adolescent trials network for HIV/AIDS interventions. Predictors of condom use in a multisite study of high-risk youth living with HIV. AIDS Educ Prev 2010; 22(1): 1-14.
[http://dx.doi.org/10.1521/aeap.2010.22.1.1] [PMID: 20166783]
[22]
Reilly T, Woo G. Predictors of high-risk sexual behaviour among people living with HIV/AIDS. AIDS Behav 2001; 5(3): 205-17.
[http://dx.doi.org/10.1023/A:1011384408761]
[23]
Hasanah CI, Zaliha AR, Mahiran M. Factors influencing the quality of life in patients with HIV in Malaysia. Qual Life Res 2011; 20(1): 91-100.
[http://dx.doi.org/10.1007/s11136-010-9729-y] [PMID: 20737215]
[24]
Rabkin JG. HIV and depression: 2008 review and update. Curr HIV/AIDS Rep 2008; 5(4): 163-71.
[http://dx.doi.org/10.1007/s11904-008-0025-1] [PMID: 18838056]
[25]
Valente SM. Depression and HIV disease. J Assoc Nurses AIDS Care 2003; 14(2): 41-51.
[http://dx.doi.org/10.1177/1055329002250993] [PMID: 12698765]
[26]
Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry 2001; 58(8): 721-8.
[http://dx.doi.org/10.1001/archpsyc.58.8.721] [PMID: 11483137]
[27]
Ferrando S, Evans S, Goggin K, Sewell M, Fishman B, Rabkin J. Fatigue in HIV illness: relationship to depression, physical limitations, and disability. Psychosom Med 1998; 60(6): 759-64.
[http://dx.doi.org/10.1097/00006842-199811000-00019] [PMID: 9847037]
[28]
Evans S, Ferrando S, Sewell M, Goggin K, Fishman B, Rabkin J. Pain and depression in HIV illness. Psychosomatics 1998; 39(6): 528-35.
[http://dx.doi.org/10.1016/S0033-3182(98)71285-X] [PMID: 9819953]
[29]
Rabkin JG, Goetz RR, Remien RH, Williams JB, Todak G, Gorman JM. Stability of mood despite HIV illness progression in a group of homosexual men. Am J Psychiatry 1997; 154(2): 231-8.
[http://dx.doi.org/10.1176/ajp.154.2.231] [PMID: 9016273]
[30]
Brown GR, Rundell JR, McManis SE, Kendall SN, Zachary R, Temoshok L. Prevalence of psychiatric disorders in early stages of HIV infection. Psychosom Med 1992; 54(5): 588-601.
[http://dx.doi.org/10.1097/00006842-199209000-00006] [PMID: 1438661]
[31]
Williams JB, Rabkin JG, Remien RH, Gorman JM, Ehrhardt AA. Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection. II. Standardized clinical assessment of current and lifetime psychopathology. Arch Gen Psychiatry 1991; 48(2): 124-30.
[http://dx.doi.org/10.1001/archpsyc.1991.01810260032005] [PMID: 1671198]
[32]
Tung MY, Lee MHG, Ng CG, John TJT, Adeeba K. Identifying depression among the human immunodeficiency virus (HIV) patients in University Malaya Medical Centre, Kuala Lumpur, Malaysia. Asian J Psychiatr 2009; 10(2): 135-47.
[33]
Zahiruddin O, Nor Asyikin F, Rahimah Z, Sharifah Zubaidiah SJ, Maruzairi H. Religiosity in Malay patients with HIV/AIDS: Correlation with emotional distress. Middle East J Sci Res 2015; 23(2): 170-4.
[34]
Crane PK, Gibbons LE, Willig JH, et al. Measuring depression levels in HIV-infected patients as part of routine clinical care using the nine-item Patient Health Questionnaire (PHQ-9). AIDS Care 2010; 22(7): 874-85.
[http://dx.doi.org/10.1080/09540120903483034] [PMID: 20635252]
[35]
Belete AA, Andaregie G, Tareke M, Birhan T, Azale T. Prevalence of anxiety and associated factors among people living with HIV/AIDS at Debretabor General Hospital, Anti Retro Viral Clinic Debretabor, Ambara, Ethiopia. Am J Psychiatry Neurosci 2014; 2(6): 109-14.
[http://dx.doi.org/10.11648/j.ajpn.20140206.15]
[36]
Morrison SD, Banushi VH, Sarnquist C, et al. Levels of self-reported depression and anxiety among HIV-positive patients in Albania: a cross-sectional study. Croat Med J 2011; 52(5): 622-8.
[http://dx.doi.org/10.3325/cmj.2011.52.622] [PMID: 21990080]
[37]
Kemppainen JK, Holzemer WL, Nokes K, et al. Self-care management of anxiety and fear in HIV disease. J Assoc Nurses AIDS Care 2003; 14(2): 21-9.
[http://dx.doi.org/10.1177/1055329002250958] [PMID: 12698763]
[38]
Ngssanga PW. Prevalence of anxiety and depression among HIV/AIDS patients attending the Comprehensive Care Centre (CCC), Kenyatta National Hospital (KNH). MS dissertation. Nairobi: University of Nairobi 2011.
[39]
Olagunju AT, Adeyemi JD, Erinfolami AR, Ogundipe OA. Factors associated with anxiety disorders among HIV-positive attendees of an HIV clinic in Lagos, Nigeria. Int J STD AIDS 2012; 23(6): 389-93.
[http://dx.doi.org/10.1258/ijsa.2011.011200] [PMID: 22807530]
[40]
Kalichman SC. Psychological and social correlates of high-risk sexual behaviour among men and women living with HIV/AIDS. AIDS Care 1999; 11(4): 415-27.
[http://dx.doi.org/10.1080/09540129947794] [PMID: 10533534]
[41]
Offir JF. Reasons for inconsistent AIDS-preventive behaviours among gay men. J Sex Res 1993; 30: 62-9.
[http://dx.doi.org/10.1080/00224499309551679]
[42]
McKirnan DJ, Ostrow DG, Hope B. Sex, drugs and escape: a psychological model of HIV-risk sexual behaviours. AIDS Care 1996; 8(6): 655-69.
[http://dx.doi.org/10.1080/09540129650125371] [PMID: 8993716]
[43]
O’Cleirigh C, Newcomb ME, Mayer KH, Skeer M, Traeger L, Safren SA. Moderate levels of depression predict sexual transmission risk in HIV-infected MSM: a longitudinal analysis of data from six sites involved in a “prevention for positives” study. AIDS Behav 2013; 17(5): 1764-9.
[http://dx.doi.org/10.1007/s10461-013-0462-8] [PMID: 23605154]
[44]
Allgöwer A, Wardle J, Steptoe A. Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychol 2001; 20(3): 223-7.
[http://dx.doi.org/10.1037/0278-6133.20.3.223] [PMID: 11403220]
[45]
Owe-Larsson B, Säll L, Salamon E, Allgulander C. HIV infection and psychiatric illness. Afr J Psychiatry 2009; 12(2): 115-28.
[http://dx.doi.org/10.4314/ajpsy.v12i2.43729] [PMID: 19582313]
[46]
Ickovics JR, Hamburger ME, Vlahov D, et al. HIV Epidemiology research study group. Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: longitudinal analysis from the HIV epidemiology research study. JAMA 2001; 285(11): 1466-74.
[http://dx.doi.org/10.1001/jama.285.11.1466] [PMID: 11255423]
[47]
Eaton LA, Kalichman SC. Changes in transmission risk behaviors across stages of HIV disease among people living with HIV. J Assoc Nurses AIDS Care 2009; 20(1): 39-49.
[http://dx.doi.org/10.1016/j.jana.2008.10.005] [PMID: 19118770]
[48]
van Kesteren NM, Hospers HJ, Kok G. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Couns 2007; 65(1): 5-20.
[http://dx.doi.org/10.1016/j.pec.2006.09.003] [PMID: 17098392]
[49]
Marks G, Crepaz N. HIV-positive men’s sexual practices in the context of self-disclosure of HIV status. J Acquir Immune Defic Syndr 2001; 27(1): 79-85.
[http://dx.doi.org/10.1097/00042560-200105010-00013] [PMID: 11404524]
[50]
Olley BO, Seedat S, Gxamza F, Reuter H, Stein DJ. Determinants of unprotected sex among HIV-positive patients in South Africa. AIDS Care 2005; 17(1): 1-9.
[http://dx.doi.org/10.1080/095401204123315089] [PMID: 15832829]
[51]
Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA 2004; 292(2): 224-36.
[http://dx.doi.org/10.1001/jama.292.2.224] [PMID: 15249572]
[52]
Kübler-Ross E, Wessler S, Avioli LV. On death and dying. JAMA 1972; 221(2): 174-9.
[http://dx.doi.org/10.1001/jama.1972.03200150040010] [PMID: 5067627]
[53]
Wringe A, Roura M, Urassa M, Busza J, Athanas V, Zaba B. Doubts, denial and divine intervention: understanding delayed attendance and poor retention rates at a HIV treatment programme in rural Tanzania. AIDS Care 2009; 21(5): 632-7.
[http://dx.doi.org/10.1080/09540120802385629] [PMID: 19444672]
[54]
Olley BO. Higher-risk sexual behaviour among HIV patients receiving antiretroviral treatment in Ibadan, Nigeria. Afr J AIDS Res 2008; 7(1): 71-8.
[PMID: 25871273]
[55]
Bingman C, Marks G, Crepaz N. Attribution about one’s HIV infection and unsafe sex in seropositive men who have sex with men. AIDS Behav 2001; 5: 283-9.
[http://dx.doi.org/10.1023/A:1011348828325]
[56]
Crepaz N, Marks G. Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychol 2001; 20(4): 291-9.
[http://dx.doi.org/10.1037/0278-6133.20.4.291] [PMID: 11515741]

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