A comparative study of anxiety among HIV seropositive individuals, cancer patients and individuals from the normative population

Excessive anxiety contributes to a sense of helplessness in which a person feels little control over the present or future and continues maladaptive behaviour patterns. In view of the negative influence of long standing anxiety, the present study attempts to find an answer regarding the possible differences between the prevalence and impact of anxiety in HIV seropositive individuals, cancer patients and individuals from the normative population. Anxiety is a major health harzard in HIV seropositive individuals. This is so because it is probably one of the factors responsible for the quick progression of their HIV seropositive status to AIDS. Method: The sample consisted of 180 subjects. Half of these individuals (90) came from Zambia and the remaining 90 came from India. Out of each group of 90 individuals, 30 were HIV seropositive individuals, 30 were HIV negative but with cancer and 30 were individuals from the normative population (having none of the above two mentioned conditions i.e. HIV or Cancer). In Zambia, the sample was drawn from the University Teaching Hospital (UTH), Kara Counseling - Hope house, Mother Theresa Hospice and Network of Zambian people living with HIV (NZP+). In India the sample was drawn from Snehandan, Karnataka network for people living with HIV (KNP+), and Kidwai Hospital. The technique of assessment used was the Symptoms Questionnaire developed 1 used to assess anxiety and physical illness behavior (somatic symptoms). The data obtained was analyzed using‘t’ tests and analysis of covariance. In the present investigation an attempt was made to explore the intensity of anxiety in HIV+ individuals, Cancer patients and individuals from the normative population. Conclusion: The findings of the present study reveal that HIV+ individuals and cancer patients have higher levels of anxiety than individuals from the normative population. Anxiety is also found to be positively correlated with physical illness behavior. This indicates that high level of anxiety and physical illness behavior seem to co- exist. It’s therefore likely that a high level of anxiety is a core factor that might be responsible for the quick progression of HIV infection into AIDS

Effects of gender based violence on neurocognitive functioning in HIV positive individuals

Background: Gender based violence is being recognized as a global problem1. Given the rampant trends of violence against women and girls in Zambia which include battery, sexual abuse and exploitation, sexual cleansing, assault and other forms of violence2, women are prone to increasingly mental health problems.Methodology: This was a cross sectional survey study ccomprising of 263 HIV+ adults aged between 20 and 65. An International Neurobehavioral Test Battery (INTB) was used to review the effects of GBV on neurocognitive functioning among HIV positive individuals in Lusaka's selected urban clinics.Results: Respondents who experienced GBV showed cognition deficits in working memory, verbal learning and recall. Pearson's correlation test showed a negative correlation on both psychological and sexual abuse on working memory r (263) = -.19, p = .002; r (263) = -.16, p = .008 and verbal learning r (263) = -.15, p = .018; r (263) = -.17, p = .006 respectively. On recall memory tests, only sexually abused respondents indicated significant negative correlation, r = -.12, n = 263, p = .044.Conclusion: The finding of the present study suggests that GBV and depressive symptoms are independent predictors of neurocognitive deficits in HIV positive women in Zambia.Key words: Gender Based Violence, Neurocognitive functioning, HIV positive individual

Mental Health Problems in Residential Care for Street Children

Background: Previous research has established high mental health problems in residential care for children. However, in Zambia little is known about the mental health of this peculiar group of young people. The study prescribed in this paper therefore, aimed to explore the mental health problems of street children in residential care and examine the relationship between multiple mental health problems (co-morbidity) and levels of stress.Methodology: The study utilized a sample of 74 street children (6 girls and 68 boys) in residential care aged 7-17 years. To collect data on children's mental health problems the Strengths and Difficulties Questionnaire (SDQ) was administered to agency carers and adolescents (if older than 11).Results: Nearly three quarters of street children in residential care were rated as having a mental health problem, as indicated by findings from both the self rated SDQ and the Carers' SDQ i.e. 48 children (76.1%) and 54 children (73.0%) respectively. Out of this population approximately one third were assessed as having multiple mental health problems i.e. 22 children (34.9%) and 33(44.6%) respectively. The study also found a significant relationship between multiple mental health problems (co-morbidity) and levels of stress.Conclusion: Street children in residential care are a high risk population to mental health problems. In addition, children with multiple mental health problems are much more likely to have high levels of stress.Keywords: street children, residential care, mental health problems, stres

Social Wellbeing Predictor of illness behavior among HIV seropositive individuals

Objective: The objective of the present study was to compare the social wellbeing of HIV seropositive individuals and individuals the normative population who are not HIV positive to find out how social support affects physical well-being.Design: Amultiple group design was used to assess the intensity and impact of social support on HIV seropositive individuals, and individuals from the normative population. The study utilized a cohort method which lasted a period of four years.Main outcome measure: Social support and physical wellbeingResults: Totals of 120 subjects - drawn from different organizations/institutions in Zambia and India were enrolled into the study. The descriptive analysis of Indian participants shows that HIV seropositive who received inadequate social support obtained 65% on somatic symptoms while individuals from the normative population obtained 43.3% From Zambia 67% of the HIV seropositive individuals who received inadequate social support experienced somatic symptoms in the recent past as against 50% individuals from the normative population. Regarding social support from friends and family, the 'F' ratio for diagnosis and nationality was significant at 0.01 revealing that HIV+ individuals obtained the least social support. Correlation between the level of physical illness behavior [somatic symptoms] and social support from friends was found to be -0.389 while that for social support from family was - 0.307. This indicated that physical illness behavior is negatively and significantly correlated with perceived social support from friends and family.Conclusion: When the level of social support is perceived to be high by an individual, then it's likely that physical illness behavior will be low because those who had adequate social support from either their friends or families had less illness behaviour. The results therefore illustrate that less levels of social support and physical illness behavior seem to co-exist. Therefore provision of adequate social support should be included in the management and treatment of HIVseropositive individuals in order to enhance their quality of life.Keywords: Social support, somatic symptoms, HIV seropositiv

Characteristics of Child Sexual Abuse in Zambia

Child Sexual Abuse (CSA)is a problem in many countries in the world including Zambia. The effects of CSA are both physical (genital trauma, contraction of infections, pregnancy, etc) and psychosocial (emotional dysregulation, bed wetting, regression of milestones, relational problems, poor self-esteem and other psychiatric diagnosis such as depression, eating disorders, substance misuse disorders, dissociative anxiety disorders, anxiety disorders, posttraumatic stress disorder (PTSD), etc). As a result of its effects, CSA is a psychiatric emergency. However, little data exists in subsaharan Africa). Knowing the characteristics of CSA in our setting, aids early identification and intervention.Objective: To describe the characteristics of child sexual abuse (CSA) among sexually abused children from the CSA centre at University Teaching Hospital (UTH).Design: Cross-sectional study based on information from CSA centre records of children aged 4 to 15 years.Main Outcomes: There were 192 participants in the study with only 3 boys. Teenagers constituted almost 50% of the study population with median age = 13, mean age = 11. Ninety eight percent of the referrals were from the Police. All the abusers were maleswith neighbours, boyfriends and non-relative adults constituting over 50% of the abusers in the study. Penile penetration was the main feature of the abuse with only one in twenty abusers being reported to have used condoms. Physical Force was the main mode of engagement used on the children.Conclusions: Most of the sexual abuse involves unprotected penetrative sex. The police should be included in planned care for CSA victims