Depression, alcohol abuse, and disclosure of HIV serostatus among rural HIV-positive individuals in western Uganda

E Nakimuli-Mpungu^1,2, G Munyaneza^3,4
1Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; ²Department of Psychiatry, Makerere College of Health Sciences, School of Medicine, Kampala, Uganda; ³Butabika School of Psychiatric Clinical Officers, Ministry of Education, Kampala, Uganda; ⁴Rushere Community Hospital, Rushere, Uganda

Introduction: Research into psychological factors associated with disclosure of human immunodeficiency virus (HIV) serostatus in low resource settings is limited. The primary aim of this study was to determine the relationship between depression, alcohol abuse, and disclosure of HIV serostatus to social networks.
Methods: We performed a cross-sectional study in which 244 HIV-positive individuals were examined for disclosure of HIV-positive serostatus and assessed for DSM-IV (Diagnostic Statistical Manual, fourth edition)-defined major depression and alcohol abuse disorder. Multiple regression models were used to determine factors independently associated with major depression, alcohol abuse, and disclosure of HIV serostatus.
Results: Of the 244 study participants, the majority 210 (86%) had disclosed their HIV serostatus. Among those who disclosed their HIV serostatus, 48 (23%) regretted this disclosure. The majority (40%) met DSM-IV criteria for depression, while (7.8%) met DSM-IV criteria for alcohol abuse. Disclosure was protective against alcohol abuse (odds ratio [OR] = 0.21; P = 0.016) but not depression (OR = 0.68; P = 0.38); and was associated with time since HIV diagnosis (OR = 1.39; P = 0.007) and HIV pretest counseling (OR = 3.9; P = 0.045).
Conclusion: Disclosure of HIV serostatus was protective against alcohol abuse but not depression, while regret of disclosure was significantly associated with depression.

Keywords: alcohol abuse, HIVstatus, depression, disclosure