Article

Mental health and sexual risk behaviours in a South African township: A community-based cross-sectional study

Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Public Health (Impact Factor: 1.48). 07/2006; 120(6):534-42. DOI: 10.1016/j.puhe.2006.01.009
Source: PubMed

ABSTRACT Despite the high prevalence of both mental illness and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in developing countries, there are few data on the association between different forms of mental illness and sexual risk behaviours in resource-poor settings. The objective of this study was to examine the association between mental illness and HIV risk behaviours in a South African township.
A cross-sectional study was performed among 645 individuals living in households selected at random.
A self-administered translated questionnaire investigated sexual risk behaviours [including sexual partners, condom use, casual sexual contacts, and sex in exchange for money, drugs or a place to stay (transactional sex)], depression (measured using the Center for Epidemiological Studies Depression Scale), alcohol abuse (from the Alcohol Use Disorders Identification Test), and post-traumatic stress disorder (based on the Life Event Checklist).
Of the 645 individuals who completed the survey, 33% reported depression, 17% reported alcohol abuse, and 15% reported post-traumatic stress disorder. After adjusting for demographic characteristics, the presence of any of these three conditions was strongly associated with experiences of forced sex [adjusted odds ratio (AOR) 2.53; 95% confidence intervals (CI) 1.60-4.02], transactional sex (AOR 2.88; 95% CI 1.29-6.48) and increased condom use (AOR 2.07; 95% CI 1.32-3.25).
These findings emphasize the substantial burden of mental illness in this setting, and its association with forced and transactional sex. The temporal nature of these associations is not always clear from this cross-sectional study, and additional prospective research is required. Public health interventions are needed to address the dual burden of HIV/AIDS and mental illness in this and similar settings.

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    • "sive disorders . Approximately one fifth of the study participants screened positive for significant levels of de - pressive symptomatology . While the figure seems relatively high , a community - based study of a South Africa township estimated that one third ( 33% ) of its inhabitants reported significant levels of de - pressive symptomatology ( Smit et al . , 2006 ) . The use of screening tools based on self - report is a limitation of our study , possibly biasing the estimate . Notwithstanding these limitations , it is clear that spatial segregation and discriminatory policies under the apartheid regime contributed to both the creation and neglect of concentrated , disadvantaged neigh - borhoods"
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    • "In fact, there is evidence that condom use is more common among persons involved in relationships with decreased intimacy and feeling less love for their partners (Aalsma, Fortenberry, Sayegh, & Orr, 2006; Civic, 1999). Moreover, condom use or reduced frequency of PVI without condoms have been associated with more use of immature defense mechanisms (Costa & Brody, 2008), depression (Gallup, Burch, & Platek, 2002; Morrill, Ickovics, Golubchikov, Beren, & Rodin, 1996; Smit et al., 2006), poorer immune function (Peters et al., 2004) and higher body mass index (Akers et al., 2009). A series of studies have shown a relationship of history of condom use or coitus interruptus with greater risk of breast cancer (Gjorgov, 1978, 1998; Le et al., 1989; Vessey et al., 1983). "
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