Skip to main content
SpringerLink
Log in
Book cover

Brain Degeneration and Dementia in Sub-Saharan Africa pp 111–133Cite as

Psychiatric Aspects of HIV Infection in Sub-Saharan Africa

  • Chapter

  • 519 Accesses

Abstract

Psychiatric assessment should always be incorporated into any assessment of patients with HIV/AIDS. To begin the process of HIV care, routine HIV testing coupled with pre- and post-test counseling should be offered to patients accessing outpatient and inpatient mental health services. Referral networks to other healthcare facilities should be put in place so that medical assessments to rule out organic causes can be treated. Mental health care providers should be equipped with skills and tools to provide prevention interventions for persons living with mental disorder and HIV/AIDS. Likewise, HIV healthcare personnel need to be equipped with skills and tools to be able to carry out routine mental health assessments/screening for the common mental health problems in HIV/AIDS.

Lastly, HIV infection causes significant brain degeneration with resultant affective (depression, mania), psychotic, anxiety and cognitive disorders, the latter commonly referred to as HIV-Associated neurocognitive disorders or HAND. These neuropsychiatric disorders occur in both children and adults. Untreated, they will compromise adherence to treatment initiatives and pose significant HIV-infection risk behavior. All this calls for integration of mental health care in any HIV-care program for their early detection and treatment for better outcomes and improved quality of life for PLWHA and for prevention strategies if we are to stem the epidemic.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. World-Health-Organization. The global burden of disease: 2008 update. Geneva; 2008.

    Google Scholar 

  2. Prince M, et al. No health without mental health. Lancet. 2007;370(9590):859–77.

    Article  PubMed  Google Scholar 

  3. Gallego L, Barreiro P, Lopez-Ibor JJ. Diagnosis and clinical features of major neuropsychiatric disorders in HIV infection. AIDS Rev. 2011;13(3):171–9.

    PubMed  Google Scholar 

  4. Hendershot CS, et al. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009;52(2):180–202.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Gonzalez JS, et al. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7.

    PubMed  Google Scholar 

  6. Olley BO, Seedat S, Stein DJ. Psychopathology and coping in recently diagnosed HIV/AIDS patients. S Afr Med J (Suid-Afrikaanse tydskrif vir geneeskunde). 2004;94(9):720, 722.

    Google Scholar 

  7. Cournos F, McKinnon K, Wainberg M. What can mental health interventions contribute to the global struggle against HIV/AIDS? World Psychiatry. 2005;4(3):135–41.

    PubMed Central  PubMed  Google Scholar 

  8. Collins PY, et al. What is the relevance of mental health to HIV/AIDS care and treatment programs in developing countries? A systematic review. AIDS. 2006;20(12):1571–82.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Maj M, et al. WHO neuropsychiatric AIDS study, cross-sectional phase I. Study design and psychiatric findings. Arch Gen Psychiatry. 1994;51(1):39–49.

    Article  CAS  PubMed  Google Scholar 

  10. Pearson CR., MA. Micek J, Pfeiffer P, Montoya E, Matediane T, Jonasse A, Cunguara D, Rao SS, Gloyd. “One year after ART initiation: psychosocial factors associated with stigma among HIV-positive Mozambicans.” AIDS and Behavior. 2009;13(6):1189–96.

    Google Scholar 

  11. Cohen MH, Fabri M, Cai X, Shi Q, Hoover DR, Binagwaho A, Culhane MA, Mukanyonga H, Karegeya DK, Anastos K. Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women. J Womens Health (Larchmt). 2009;18(11):1783–91.

    Article  Google Scholar 

  12. Adewuya AO, Afolabi MO, Ola BA, Ogundele OA, Ajibare AO, Oladipo BF, Fakande I. Relationship between depression and quality of life in persons with HIV infection in Nigeria. Int J Psychiatry Med. 2008;38(1):43–51.

    Article  PubMed  Google Scholar 

  13. Olley BO, Seedat S, Stein DJ. Persistence of psychiatric disorders in a cohort of HIV/AIDS patients in South Africa: a 6-month follow-up study. J Psychosom Res. 2006;61(4):479–84.

    Article  PubMed  Google Scholar 

  14. Spies G, Kader K, Kidd M, Smit J, Myer L, Stein DJ, et al. Validity of the K-10 in detecting DSM-IV-defined depression and anxiety disorders among HIV-infected individuals. AIDS Care. 2009;21(9):1163–8.

    Article  CAS  PubMed  Google Scholar 

  15. Nakimuli-Mpungu E, et al. Clinical presentation of bipolar mania in HIV-positive patients in Uganda. Psychosomatics. 2009;50(4):325–30.

    Article  PubMed  Google Scholar 

  16. Nakasujja N, Skolasky RL, Musisi S, Allebeck P, Robertson K, Ronald A, et al. Depression symptoms and cognitive function among individuals with advanced HIV infection initiating HAART in Uganda. BMC Psychiatry. 2010;10(1):44.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet. 1997;349(9064):1498–504.

    Article  CAS  PubMed  Google Scholar 

  18. Rabkin JG. HIV and depression: 2008 review and update. Curr HIV/AIDS Rep. 2008;5(4):163–71.

    Article  PubMed  Google Scholar 

  19. Etienne M, et al. Indicators of adherence to antiretroviral therapy treatment among HIV/AIDS patients in 5 African countries. J Int Assoc Physicians AIDS Care. 2010;9(2):98–103.

    Article  Google Scholar 

  20. Kagee A, Martin L. Symptoms of depression and anxiety among a sample of South African patients living with HIV. AIDS Care. 2010;22(2):159–65.

    Article  PubMed  Google Scholar 

  21. Marwick KF, Kaaya SF. Prevalence of depression and anxiety disorders in HIV-positive outpatients in rural Tanzania. AIDS Care. 2010;22(4):415–9.

    Article  PubMed  Google Scholar 

  22. Myer L, et al. The mental health impact of AIDS-related mortality in South Africa: a national study. J Epidemiol Community Health. 2009;63(4):293–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Bass JK, Bolton PA, Murray LK. Do not forget culture when studying mental health. Lancet. 2007;370(9591):918–9.

    Article  PubMed  Google Scholar 

  24. Ferrando SJ, Freyberg Z. Treatment of depression in HIV positive individuals: a critical review. Int Rev Psychiatry. 2008;20(1):61–71.

    Article  PubMed  Google Scholar 

  25. Nakimuli-Mpungu E, Katabira E, Nachega JB, Musisi S, Bass J. Prevalence and factors associated with depressive disorders in an HIV + rural patient population in southern Uganda. J Affect Disord. 2011. 10.1016/j.jad.2011.07.009.

  26. Byakika-Tusiime J, Crane J, Oyugi JH, Ragland K, Kawuma A, Musoke P, Bangsberg DR. Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-Plus family treatment model: role of depression in declining adherence over time. AIDS Behav. 2009;13 Suppl 1:82–91.

    Article  PubMed  Google Scholar 

  27. Peltzer K, Friend-du Preez N, Ramlagan S, Anderson J. Antiretroviral treatment adherence among HIV patients in KwaZulu-natal, South Africa. BMC Public Health. 2010;10:111.

    Article  PubMed Central  Google Scholar 

  28. Adewuya AO, Afolabi MO, Ola BA, Ogundele OA, Ajibare AO, Oladipo BF, Fakande I. The effect of psychological distress on medication adherence in persons with HIV infection in Nigeria. Psychosomatics. 2010;51(1):68–73.

    Article  PubMed  Google Scholar 

  29. Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K. Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in southwest Ethiopia. BMC Public Health. 2008;8:265.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Bunnell RE, Nassozi J, Marum E, Mubangizi J, Malamba S, Dillon B, Kalule J, Bahizi J, Musoke N, Mermin JH. Living with discordance: knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda. AIDS Care. 2005;17(8):999–1012.

    Article  CAS  PubMed  Google Scholar 

  31. Murray LK, Semrau K, McCurley E, Thea DM, Scott N, Mwiya M, Kankasa C, Bass J, Bolton P. Barriers to acceptance and adherence of antiretroviral therapy in urban Zambian women: a qualitative study. AIDS Care. 2009;21(1):78–86.

    Article  PubMed Central  Google Scholar 

  32. Nakimuli-Mpungu E, Mojtabai R, Alexandre P, Musisi S, Katabira E, Nachega JB, Tresman G, Bass JK. Lifetime depressive disorders and adherence to anti-retroviral therapy in a rural HIV clinic in southern Uganda: a case-control study. J Affct Disord. 2012. doi:10.1016/j.jad.2011.07.009.

  33. Bradley MV, Remien RH, Dolezal C. Depression symptoms and sexual HIV risk behavior among serodiscordant couples. Psychosom Med. 2008;70(2):186–91.

    Article  PubMed  Google Scholar 

  34. Kelly JA, et al. Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychol. 1993;12(3):215–9.

    Article  CAS  PubMed  Google Scholar 

  35. Ickovics JR, et al. 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.

    Article  CAS  PubMed  Google Scholar 

  36. Leserman J, et al. Relation of lifetime trauma and depressive symptoms to mortality in HIV. Am J Psychiatry. 2007;164(11):1707–13.

    Article  PubMed  Google Scholar 

  37. Kacanek D, et al. Incident depression symptoms are associated with poorer HAART adherence: a longitudinal analysis from the Nutrition for Healthy Living study. J Acquir Immune Defic Syndr. 2010;53(2):266–72.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Carrieri MP, et al. Failure to maintain adherence to HAART in a cohort of French HIV-positive injecting drug users. Int J Behav Med. 2003;10(1):1–14.

    Article  CAS  PubMed  Google Scholar 

  39. Horberg MA, et al. Effects of depression and selective serotonin reuptake inhibitor use on adherence to highly active antiretroviral therapy and on clinical outcomes in HIV-infected patients. J Acquir Immune Defic Syndr. 2008;47(3):384–90.

    Article  CAS  PubMed  Google Scholar 

  40. Chesney M. Adherence to HAART regimens. AIDS Patient Care STDS. 2003;17(4):169–77.

    Article  PubMed  Google Scholar 

  41. Bangsberg DR. Preventing HIV antiretroviral resistance through better monitoring of treatment adherence. J Infect Dis. 2008;197 Suppl 3:S272–8.

    Article  PubMed  Google Scholar 

  42. Kozal MJ, et al. HIV drug resistance and HIV transmission risk behaviors among active injection drug users. J Acquir Immune Defic Syndr. 2005;40(1):106–9.

    Article  PubMed  Google Scholar 

  43. Pence BW, O’ÄôDonnell JK, Gaynes BN. Falling through the cracks: the gaps between depression prevalence, diagnosis, treatment, and response in HIV care. AIDS. 2012;26(5):656–8. doi:10.1097/QAD.0b013e3283519aae.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Wagner GJ. Predictors of antiretroviral adherence as measured by self-report, electronic monitoring, and medication diaries. AIDS Patient Care STDS. 2002;16(12):599–608.

    Article  PubMed  Google Scholar 

  45. Nilsson Schonnesson L, et al. Factors associated with suboptimal antiretroviral therapy adherence to dose, schedule, and dietary instructions. AIDS Behav. 2007;11(2):175–83.

    Article  PubMed  Google Scholar 

  46. Ammassari A, et al. Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics. 2004;45(5):394–402.

    Article  PubMed  Google Scholar 

  47. Hartzell JD, Janke IE, Weintrob AC. Impact of depression on HIV outcomes in the HAART era. J Antimicrob Chemother. 2008;62(2):246–55.

    Article  CAS  PubMed  Google Scholar 

  48. Cook JA, et al. Depressive symptoms and AIDS-related mortality among a multisite cohort of HIV-positive women. Am J Public Health. 2004;94(7):1133–40.

    Article  PubMed Central  Google Scholar 

  49. Bouhnik AD, et al. Depression and clinical progression in HIV-infected drug users treated with highly active antiretroviral therapy. Antivir Ther. 2005;10(1):53–61.

    CAS  PubMed  Google Scholar 

  50. Ironson G, et al. Psychosocial factors predict CD4 and viral load change in men and women with human immunodeficiency virus in the era of highly active antiretroviral treatment. Psychosom Med. 2005;67(6):1013–21.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Asch SM, et al. Underdiagnosis of depression in HIV: who are we missing? J Gen Intern Med. 2003;18(6):450–60.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Schmidt U, Miller D. Two cases of hypomania in AIDS. Br J Psychiatry. 1988;152:839–42.

    Article  CAS  PubMed  Google Scholar 

  53. Brouillette MJ, Chouinard G, Lalonde R. Didanosine-induced mania in HIV infection (letter). Am J Psychiatry. 1994;151:1839–40.

    CAS  PubMed  Google Scholar 

  54. Wright JM, Sachder PS, Perkins RJ, Rodriguez P. Zidovudine-related mania. Med J Aust. 1989;15:334–41.

    Google Scholar 

  55. Maxwell S, Scheftner WA, Kessler MA, Busch K. Manic syndromes associated with zidovudine therapy (letter). JAMA. 1988;259:3406–7.

    Article  CAS  Google Scholar 

  56. Johannessen DJ, Wilson LG. Mania with cryptococcal meningitis in two AIDS patients. J Clin Psychiatry. 1988;49:200–1.

    CAS  PubMed  Google Scholar 

  57. Lyketsos CG, Schwartz J, Fishman M, Treisman G. AIDS mania. J Neuropsychiatr Clin Neurosci. 1997;9:277–9.

    Article  CAS  Google Scholar 

  58. Kieburtz K, Zettelmaier AE, Ketonen L, Tuite M, Caine ED. Manic syndrome in AIDS. Am J Psychiatry. 1991;148:1068–70.

    Article  CAS  PubMed  Google Scholar 

  59. Lyketsos CG, Hanson AL, Fishman M, Rosenblatt A, McHugh PR, Treisman GJ. Manic syndrome early and late in the course of HIV. Am J Psychiatry. 1993;150:326–7.

    Article  CAS  PubMed  Google Scholar 

  60. Ellen SR, Judd FK, Mijch AM, Cockram A. Secondary mania in patients with HIV infection. Aust N Z J Psychiatry. 1999;3:353–60.

    Article  Google Scholar 

  61. Nakimuli-Mpungu E, Musisi S, Kiwuwa-Mpungu S, Katabira E. Early-onset versus late-onset HIV-related secondary mania in Uganda. Psychosomatics. 2008;49(6):530–4.

    Article  PubMed  Google Scholar 

  62. Mijch AM, Judd FK, Lyketsos CG, Ellen S, Cockram A. Secondary mania in patients with HIV infection: are antiretroviral drugs effective? J Neuropsychiatr Clin Neurosci. 1999;11:475–80.

    Article  CAS  Google Scholar 

  63. Nakimuli-Mpungu E, Musisi S, Kiwuwa S, et al. Primary mania versus HIV-related secondary mania in Uganda. Am J Psychiatry. 2006;163:1349–54.

    Article  PubMed  Google Scholar 

  64. Kupler DJ, Frank E, Grochocinski VJ, et al. African-American participants in a bipolar disorder registry: clinical and treatment characteristics. Bipolar Disord. 2005;7:82–8.

    Article  Google Scholar 

  65. Perretta P, Akiskai HS, Nisita C, et al. The high prevalence of bipolar II and associated cyclothymic and hyperthymic temperatures in HIV-positive patients. J Affect Disord. 1998;50:215–24.

    Article  CAS  PubMed  Google Scholar 

  66. Joint United Nations Program on HIV/AIDS, World Health Organization. AIDS epidermic update: December 2005. Publication UN-AIDS/05.19E. Geneva, UNAIDS; 2005. Available at http://www.unaids.org/epi/2005/doc/EPlupdate2005_html_en/epi05_00_en.htm

  67. Smith DJ, Muir WJ, Blackwood DHR. Neurocognitive impairment in euthymic young adults with bipolar spectrum disorder. Bipolar Disord. 2006;8:40–6.

    Article  PubMed  Google Scholar 

  68. Kuganda S. M.Med thesis (psychiatry). Kampala: Makerere University College of Health Sciences; 2011.

    Google Scholar 

  69. Petrushkin A, Boardman J, Ovuga E. Psychiatric disorders in HIV- positive individuals in urban Uganda. Psychiatr Bull. 2005;29:455–58.

    Article  Google Scholar 

  70. Weiser SD, Wolfe WR, Bangsberg DR. The HIV epidemic among individuals with mental illness in the United States. Curr Infect Dis Rep. 2004;6(5):404–10.

    Article  PubMed  Google Scholar 

  71. Musisi S, Kinyanda E, editors. Psychiatric problems of HIV/AIDS and their management in Africa. Kampala: Fountain Publishers; 2009.

    Google Scholar 

  72. Breslau N, Kessler RC. The stressor criterion in DSM-IV posttraumatic stress disorder: an empirical investigation. Biol Psychiatry. 2001;50(9):699–704.

    Article  CAS  PubMed  Google Scholar 

  73. Martin L, Kagee A. Lifetime and HIV-related PTSD among persons recently diagnosed with HIV. AIDS Behav. 2011;15(1):125–31.

    Article  PubMed  Google Scholar 

  74. Guimaraes MD, McKinnon K, Campos LN, Melo AP, Wainberg M. HIV risk behavior of psychiatric patients with mental illness: a sample of Brazilian patients. Rev Bras Psiquiatr. 2010;32(4):351–60.

    Article  PubMed  Google Scholar 

  75. Williams DR, et al. Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study. Psychol Med. 2008;38(2):211–20.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  76. Stein DJ, et al. Lifetime prevalence of psychiatric disorders in South Africa. Br J Psychiatry J Ment Sci. 2008;192(2):112–7.

    Article  Google Scholar 

  77. Olley BO, et al. Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa. AIDS Care. 2005;17(5):550–7.

    Article  CAS  Google Scholar 

  78. Nakasujja N, Allebeck P, Agren H, Musisi S, Katabira E. Cognitive dysfunction among HIV positive and HIV negative patients with psychosis in Uganda. PLoS One. 2012;7(9):e44415.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  79. el-Mallakh RS. HIV-related psychosis. J Clin Psychiatry. 1992;53(8):293–4.

    CAS  PubMed  Google Scholar 

  80. Sewell DD, Jeste DV, Atkinson JH, Heaton RK, Hesselink JR, Wiley C, et al. HIV-associated psychosis: a study of 20 cases. San Diego HIV neurobehavioral research center group. Am J Psychiatry. 1994;151(2):237–42.

    Article  CAS  PubMed  Google Scholar 

  81. Acuda SW, Sebit MB. Serostatus surveillance testing of HIV-I infection among Zimbabwean psychiatric inpatients, in Zimbabwe. Cent Afr J Med. 1996;42(9):254–7.

    CAS  PubMed  Google Scholar 

  82. Acuda SW, Sebit MB. Prevalence of psychoactive substance use among psychiatric in-patients in Harare, Zimbabwe. Cent Afr J Med. 1997;43(8):226–9.

    CAS  PubMed  Google Scholar 

  83. Maling S, Todd J, Van der Paal L, Grosskurth H, Kinyanda E. HIV-1 seroprevalence and risk factors for HIV infection among first-time psychiatric admissions in Uganda. AIDS Care. 2011;23(2):171–8.

    Article  PubMed  Google Scholar 

  84. Singh D, Berkman A, Bresnahan M. Seroprevalence and HIV-associated factors among adults with severe mental illness – a vulnerable population. S Afr Med J. 2009;99(7):523–7.

    PubMed Central  PubMed  Google Scholar 

  85. Collins PY, Berkman A, Mestry K, Pillai A. HIV prevalence among men and women admitted to a South African public psychiatric hospital. AIDS Care. 2009;21(7):863–7.

    Article  PubMed Central  PubMed  Google Scholar 

  86. Meade CS, Sikkema KJ. HIV risk behavior among adults with severe mental illness: a systematic review. Clin Psychol Rev. 2005;25(4):433–57.

    Article  PubMed  Google Scholar 

  87. Meade CS, Fitzmaurice GM, Sanchez AK, Griffin ML, McDonald LJ, Weiss RD. The relationship of manic episodes and drug abuse to sexual risk behavior in patients with co-occurring bipolar and substance use disorders: a 15-month prospective analysis. AIDS Behav. 2011;15(8):1829–33.

    Article  PubMed Central  PubMed  Google Scholar 

  88. Carey MP, Carey KB, Kalichman SC. Risk for human immunodeficiency virus (HIV) infection among persons with severe mental illnesses. Clin Psychol Rev. 1997;17(3):271–91.

    Article  CAS  Google Scholar 

  89. Lundberg P, Johansson E, Okello E, Allebeck P, Thorson A. Sexual risk behaviours and sexual abuse in persons with severe mental illness in Uganda: a qualitative study. PLoS One. 2012;7(1):e29748.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  90. Melo AP, Cesar CC, AcurcioFde A, Campos LN, Ceccato M, Wainberg ML, et al. Individual and treatment setting predictors of HIV/AIDS knowledge among psychiatric patients and their implications in a national multisite study in Brazil. Community Ment Health J. 2010;46(5):505–16.

    Article  Google Scholar 

  91. Nachega JB, Mutamba B, Basangwa D, Nguyen H, Dowdy DW, Mills EJ, et al. Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults. Trop Med Int Health. 2013;18(1):53–7.

    Article  CAS  PubMed  Google Scholar 

  92. Joska JA, Obayemi Jr A, Cararra H, Sorsdahl K. Severe mental illness and retention in anti-retroviral care: a retrospective study. AIDS Behav. 2014;18:1–9.

    Article  Google Scholar 

  93. Ngwena J. HIV/AIDS awareness in those diagnosed with mental illness. J Psychiatr Ment Health Nurs. 2011;18(3):213–20.

    Article  CAS  PubMed  Google Scholar 

  94. Bogart LM, Fremont AM, Young AS, Pantoja P, Chinman M, Morton S, et al. Patterns of HIV care for patients with serious mental illness. AIDS Patient Care STDS. 2006;20(3):175–82.

    Article  PubMed  Google Scholar 

  95. Himelhoch S, Brown CH, Walkup J, Chander G, Korthius PT, Afful J, et al. HIV patients with psychiatric disorders are less likely to discontinue HAART. AIDS. 2009;23(13):1735–42.

    Article  PubMed Central  PubMed  Google Scholar 

  96. Agenor M, Collins PY. Preventing HIV among U.S. women of color with severe mental illness: perceptions of mental health care providers working in urban community clinics. Health Care Women Int. 2013;34(3–4):281–302.

    Article  PubMed Central  PubMed  Google Scholar 

  97. Collins PY. Challenges to HIV prevention in psychiatric settings: perceptions of South African mental health care providers. Soc Sci Med. 2006;63(4):979–90.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Makerere University College of Health Sciences, School of Medicine, 7072, Kampala, Uganda

    Etheldreda Nakimuli-Mpungu MMED (Psych), PhD

Authors
  1. Etheldreda Nakimuli-Mpungu MMED (Psych), PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Etheldreda Nakimuli-Mpungu MMED (Psych), PhD .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, Makerere University Medical School, Kampala, Uganda

    Seggane Musisi

  2. Dept. Anatomy & Cellular Biology, Tufts University School of Medicine, Boston, Massachusetts, USA

    Stanley Jacobson

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Nakimuli-Mpungu, E. (2015). Psychiatric Aspects of HIV Infection in Sub-Saharan Africa. In: Musisi, S., Jacobson, S. (eds) Brain Degeneration and Dementia in Sub-Saharan Africa. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2456-1_10

Download citation

Publish with us

Policies and ethics

Search

Navigation