AEGiS-11IAC: Prevalence and clinical profile of psychiatric morbidity in gay men with HIV infection and AIDS: comparisons with HIV-seronegative gay men and with patients with hematological malignancies.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Prevalence and clinical profile of psychiatric morbidity in gay men with HIV infection and AIDS: comparisons with HIV-seronegative gay men and with patients with hematological malignancies.

Int Conf AIDS 1996 Jul 7-12; 11:449 (abstract no. Pub.B.1073)
Viana MC, King MB; Section of Epidemiology, Institute of Psychiatry, University of London and Department of Social Medicine, Infectious Diseases Unit, Universidade Federal do Espirito Santo, Brazil. Fax: +55 27 3357206. E-mail: c.viana@npdl.ufes.b.

OBJECTIVES: 1) To identify the prevalence and clinical profile of psychiatric morbidity in gay men with HIV infection and AIDS in Sao Paulo, Brazil, and 2) to compare (1) with that found in HIV-seronegative gay men and in patients with hematological malignancies.

METHODS: This cross-sectional study was carried out in the city of Sao Paulo, Brazil, examining (a) 164 HIV seropositive gay men (Group 1), (b) 42 HIV-seronegative gay men (Group 2), and (c) 32 HIV-seronegative men with leukemia and non-Hodgkin's lymphomas (Group 3). Inclusion criteria: age ranging from 20 to 55 years; male gender and attendance at an outpatients clinic. In addition, patients in Groups 1 and 3 had their diagnoses known for at least 3 months, patients in Group 3 were under chemotherapy on an out-patient basis, and subjects in Group 3 had an HIV-seronegative test result within the past 3 months and for more than 2 weeks. All three samples were assessed using the Clinical Interview Schedule (CIS) and clinical psychiatric diagnoses were based on the DSM-III-R system of classification criteria. In addition, socio-demographic information was collected and relevant data on disease status and treatment were collected from patients' medical records.

RESULTS: The prevalence of psychiatric morbidity using a cut-off of 18 in the CIS total weighted score was 46.9% in the HIV-seropositive group, 40.5% in the HIV-seronegative group of gay men, and 28.1% in the hematology group (X2, 1 df: 3.81 p= 0.05). The clinical profile of psychiatric morbidity in Group 1 was mainly divided into disorders with central nervous system (CNS) involvement (20.7%) and anxiety/depression (40.2%). When prevalence rates of psychiatric morbidity derived from the clinical diagnosis were compared, there was a significant difference between Groups 1 and 2 and Groups 1 and 3. The most frequent DSM-III-R Axis I single diagnosis in Groups 1 and 3 was of adjustment disorder of some sort (33% and 37.5%), while in Group 2 the most common diagnosis was of generalised anxiety disorder (29%). There were no statistically significant differences in the rates of personality disorders in all groups.

CONCLUSIONS: 1. This study confirms the high prevalence rates of psychiatric morbidity associated with HIV infection and AIDS in gay men, reported in the literature from studies carried out in developed countries.2. The results from the comparison groups make it possible to identify the specific contribution of AIDS to the spectrum of psychiatric morbidity.3. The implications of these findings for the Brazilian situation are discussed.

Keywords: AEGIS, Homosexuality, Male, Acquired Immunodeficiency Syndrome, HIV Infections, Prevalence, HIV Seropositivity, Mental Disorders, Anxiety Disorders, Cross-Sectional Studies, Personality Disorders, Ambulatory Care Facilities, Commonwealth of Independent States, Brazil, Human, Male, epidemiology, ICA11

960707
PubB1073