Abstract

The aim of this study was to describe the demographics, clinical characteristics and expectations of the members of a newly established support group for HIV positive mentally ill patients. The factors associated with disclosure of status and expectations of the group, were also to be determined. All mental health care users, aged 18 years and older, with HIV and admitted to Chris Hani Baragwanath Hospital (CHBH) between March and June 2008 were invited to participate in the support group at Luthando Psychiatric HIV clinic. All the members of the support group were asked to complete a questionnaire at the first group session they attended. The questions related to demographic data (age, gender, home language, employment status, marital status, level of education, number of children); clinical data [past psychiatric illness; current diagnosis, on Antiretroviral treatment (ART)]; if they had disclosed their HIV status and the expectations of the members of the group were collected. All fifty members of the support group volunteered to complete the questionnaire resulting in a 100% response rate. The majority of the subjects were in the age range 26 - 35 years (44%); female (78%); single (88%); had 2 or more children (71%); had less than a grade 10 level of education (44%) and were unemployed (68%). The common spoken first languages of the subjects were Zulu (34%) and Tswana (20%). Only 6% of the subjects reported English as their first language. Approximately two thirds (60%) of the subjects had been diagnosed with a psychiatric illness. The current diagnoses of the members of the group included mood or psychotic symptoms secondary to HIV (25%); bipolar disorder (33%); anxiety disorders (3%) and schizophrenia (3%). Only one third of the group had been commenced on antiretroviral treatment (ARV) treatment. Two out of every three members (68%) in the group were aware of their HIV status for longer than six months. The majority (70%) of the members of the group had disclosed their status either to a family member of friend. The common expectations of the group included education (36%) and support (32%), whilst 32% had other expectations or were unsure of their expectations. This study found that mostly young females, who had dealt with the issues of disclosure of their diagnosis to a family member or friend, joined the support group with the expectation of receiving emotional support and education. The inability of individuals to cope with the burden of HIV and AIDS and a co-morbid mental illness may be associated with feelings of hopelessness and a depressed mood which may lead to decreased adherence to medication regimes, suppression of immunity and accelerated disease progression. This may also be closely associated with HIV transmission risk behaviours and increased risk of suicide attempts. It is imperative that all mentally ill patients with HIV and AIDS receiving ART be a member of a support group as it will help improve adherence and functioning.

Key words: support group, HIV/AIDS, mental illness, antiretroviral treatment (ART)