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Depressive symptomatology and suicidal ideation among HIV-infected women in India
Presented by Salma Pothiawala, United States.
Pothiawala S.1, Menezes L.1, Kim H.2, Joshi A.3, Deshpande A.3, Sinnott J.1
1University of South Florida College of Medicine, Department of Infectious Disease and International Medicine, Tampa, United States, 2University of South Florida, Center for Collaborative Research, Tampa, United States, 3Government of Maharashtra, Sir JJ Government Hospital, Mumbai, India
Objectives: 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.
Methods: Data was collected from 96 HIV+ 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. A predictive model for suicidal ideation was developed using logistic regression on data from the IDS-C30.
Results: Nearly 86% of the surveyed women were depressed. 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. In women over 30, the presence of panic/phobic symptoms was statistically significantly correlated (p = .0096).
Conclusion: 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. Targeted mental-health interventions are therefore necessary.
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