Marseille 2007
Marseille 2007
Abstract book
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Abstract #447  -  Depressive Symptomatology and Suicidal Ideation among HIV-Infected Women in India
Session:
  31.6: Quality of Life (Parallel) on Tuesday @ 11.00-12.30 in HC Chaired by Adinani Amidu, Wendee Wechsberg
Authors:
  Presenting Author:   Ms Salma Pothiawala - University of South Florida College of Medicine, United States
 
  Additional Authors:  Ms Salma Pothiawala, Dr Lynette  Menezes, Dr John Sinnott, Dr Ameeta Joshi, Dr Alka Deshpande, Dr Frank Fernandez, Mr Hyungtae Kim,  
Aim:
Depression and suicide have been linked to HIV but little research has targeted HIV-positive women in India, despite their constituting 40 percent of reported HIV/AIDS cases in the country. We sought to examine the prevalence of depressive symtomatology and suicidal ideation among HIV-infected women seeking care at the Antiretroviral Treatment (ART) Center of Sir JJ Government Hospital in Mumbai, in the high HIV prevalence state of Maharashtra.
 
Method / Issue:
Data was collected from 96 HIV-positive women, 18 and older, using a structured survey that included the Inventory of Depressive Symtomatology (IDS-C30), socio-demographic and clinical history assessments, and collection of clinical data from medical records. Ninety patients were receiving free, government-sponsored ART, and 6 had not yet begun treatment. Univariate frequencies and bivariate associations were computed using SAS. Additionally, a predictive model for suicidal ideation was developed using logistic regression on data from the IDS-C30.
 
Results / Comments:
Nearly 86% of the surveyed women were depressed. The majority of women were from the lower socioeconomic strata: 52% were unemployed, 58% had an elementary education or less, and nearly 90% (N=83) lived in households with a monthly income of Rupees 4,000 (90 USD) or below. Fifty-seven percent of women were married, 30% were widowed, and 7% were divorced. Among widowed women, all reported AIDS as their spouses cause of death. Education, household income and ART treatment were significantly associated with depression. Women with higher levels of education (p=. 0008) and higher household incomes (p=. 0783), as well as those receiving ART treatment (p=. 0526) were more likely to exhibit lower levels of depressive symptomatolgy. Eleven percent of women reported suicidal ideation. Within the IDS-C30, the following three items, as a group, correlated with the presence of suicidal ideation: outlook (self) (p=.0372), pleasure/enjoyment (not sexual) (p=.0020), and panic/phobic symptoms (p=.0077). For women ages 30 and under, lack of pleasure/enjoyment (not sexual) correlated best with the presence of suicidal ideation (p =.0115), where as in women over 30, the presence of panic/phobic symptoms was statistically significantly correlated (p = .0096).
 
Discussion:
HIV -infected women with higher levels of education, higher household incomes, and receiving ART treatment were less likely to be depressed. Women who had contemplated suicide reported greater levels of emotional stress with increased symptoms of anxiety, and a poorer self image and a bleaker outlook than those who had not considered suicide. They were also significantly more likely to experience diminished pleasure (anhedonia) consistent with core symptoms of depression. Depressed HIV+ women in India experience significant emotional distress and thoughts of suicide. Targeted interventions to improve mental health and prevent suicide will enhance the overall quality of life for these women.
 
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