A Study on Depression Among HIV/ AIDS Persons

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1 A Study on Depression Among HIV/ AIDS Persons N. HEMALATHA, Ph.D., Scholar, Karpagam, University Coimbatore, India Dr. A. SAVARIMUTHU, Dean, Department of Management Studies, St.Joseph's College (Autonomous), Tiruchirappalli Abstract HIV/AIDS have a peculiar character of affecting the immune system of the body and make body susceptible to a number of infections leading to AIDS a fatal stage of the body. It affects the entire demographic and economic structure of the society by increasing mortality rate among the youth and children who are considered as the back of the development of any nation. On the other hand the society excludes such affected in terms of avoiding; preventing their basic human rights and discriminates to the maximum level. The present aims to study about depression level among the HIV positives. In this study 209 HIV positives was selected through convenient sampling method from the Positive Network centre. The study was limited only to Tiruchirapalli district, Tamilnadu and as a part of research method, a combination of descriptive and diagnostic design was adopted. The study has revealed that the level of depression of the HIV positives. Keywords: Depression, HIV Positives Depression Feelings of depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. But true clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time. (Chandra.S, et. al. 2005) HOW ARE DEPRESSION AND HIV/AIDS LINKED? Studies show that people who are infected with HIV are more likely than the general population to develop depression. Depression affects a person's ability to follow treatment for HIV/AIDS, as well as quality of life and lifespan. Depression may seem like an unavoidable reaction to being diagnosed with HIV/AIDS. But depression is a separate illness that can and should be treated, even when a person is undergoing treatment for HIV/AIDS. (National Institute of Mental Health. 2011) Effects Of Depressed Hiv/Aids Persons Depression is a common, treatable problem in people with HIV infection. It may be due to a condition long preceding HIV infection or because of substance abuse. It might also arise during the course of the infection as a result of HIV, illnesses, or the overwhelming emotional response to HIV itself. If not treated or recognized, it can profoundly affect the quality of life and life expectancy of people who are HIV-positive. About 5% to 10% of the general population gets depressed. However, rates of depression in people with HIV are as high as 60%. Women with HIV are twice as likely as men to be depressed. Clinical depression is the most commonly observed mental health disorder among HIV-infected patients. The prevalence may be even greater among substance users. Depressive symptoms have been associated with risk behavior, non-adherence to medications, and shortened survival. Failure to recognize depression may endanger both the patient and others in the community. (Urison, 2014) Signs Of Depression For Hiv/Aids Persons Depression is a mood disorder which is common with many persons resulting in different symptoms of disorderly behavior. Symptoms of depression various from person some of the signs to seen of with the people suffering from AIDS equpled with depression are sadness. Anxiety, and irritability, loss of interest in things you used to enjoy, feelings of guilt, worthlessness, or hopelessness weight loss or gain, loss of appetite, sleep problems, fatigue, loss of concentration, low sex drive and the suicidal tendency. Diagnosing depression can be hard in someone with HIV. Some HIV symptoms and side effects of HIV drugs are the same as those of depression. These include fatigue, low sex drive, little appetite, confusion, nightmares, nervousness, and weight loss. But a true loss of interest in activities that someone used to enjoy is a sign that a person is depressed. (Mental Health and HIV/AIDS (Depression), 2011) How Important Is It For Hiv+ People To Get Needed Treatment For Depression? HIV+ve patients with depressive symptoms will benefit from treatment beyond getting relief from the depression. In fact, studies suggest that depressed HIV+ve patients who are given treatment may be more likely to adhere to, and benefit from, their treatment. Antidepressant for treatment of depression has actually been associated with a significantly lower monthly cost of medical care services. Recent research suggests that social support is highly associated with better treatment adherence for individuals with depression or anxiety. Open Access Journals Blue Ocean Research Journals 232

2 A physician treating any HIV+ve patient who is depressed must weigh the benefits of treatment-and the potential to relieve symptoms of depression-against the side-effects of the chosen treatment and the likelihood of adverse drug-drug interactions. Each patient, and each case, is individual, and must be approached as such Treatment for depression can make a significant difference in the physical and emotional well-being of individuals living with HIV. (Andriote.J.M. 2012) Reviews: The prevalence of depression among the HIV/AIDS patient was 56.7% with the following level of depression viz., minimal 109 (64%), mild 44 (25.9%), moderate 10 (5.9%), moderately severe 3 (1.8%), and4 (2.4%), severely depressed. Moreover, there was severe family dysfunction in 75 (44.1%) and moderate dysfunction in 48 (28.2%) of the respondents. Only 47 (27.6%) had highly functional family. (Shittua et., al, 2014) The prevalence of depression in H1V infected clinic populations has ranged from 22% to 88% of younger age, unemployment. lack of health insurance, low CD4 cells counts, HIV related symptoms, like not having a partner, poor quality of social support, and use of non injection drugs were significant predictors of depression in one study. (Basavaraj et., al, 2010) The HIV epidemic has evolved with the advancement of available treatment and care options. People are now living chronically with HIV/AIDS and are clinically managed with Highly Active Anti-Retroviral Therapy (HAART), which has resulted in a significant decrease in HIV-related morbidity and mortality across the globe (Palella, Jr, et al., 1998 ) Aim Of The Study The aim of this study is to assess the level of depression experienced by HIV/AIDS patients the following are the objectives with which the present study proceeded. Objectives a) To study the association of socio - demographic characteristics of the respondents with their depression level. b) To assess the level of depression of respondents. c) To study the relationship between the level of education and the level of depression. Hypothesis: a) Social exclusion and self exclusion differ with the HIV positives. b) There is significant relationship between HIV Positives demographic variables and their exclusion and depression. c) There is an association between the literacy level and the level of depression of the HIV positive people. Research Design The researcher has used the descriptive design for this study. The researcher is interested in studying about HIV positive people. The research purpose is to describe depression status as the HIV/AIDS Patients in trichy. Universe The universe for this research study were taken from the Network for positive Pepople in Trichy (NPT)+ Uyyakondan Thirumalai, Tiruchirappalli. In this study the researcher collected the data from respondents those who have registered and attended the support group meeting. In this study HIV positives were selected through convenient sampling method from the Positive Network centre. The registered individuals with HIV+ve who come for the support group meeting on a fixed date were taken into account. All those attended the meeting on the scheduled data were 209 in number. Everyone was made to be the respondents. Tools of Data Collections The researcher has collected data with the help of self prepared question and depression interview schedule. Table No.1 Shows the distribution of the respondents based on their level of Depression No. of Respondents S.No Level of depression Percentage (209) 1 Minimal depression Mild depression Moderate depression Severe depression Total Open Access Journals Blue Ocean Research Journals 233

3 The distribution of the respondents based on their level of depression. From the above table it is clear that (52.7%) of the respondents are having several level of depression nearly (20.5%) of the respondents are having mild level of depression, and only a minimum of (8.1 percent) of the respondents are having minimal level of depression. More than 70 percent of the respondents are having moderate to severe level of depression. Table No: 2 Showing the results of t-test compared different forms of exclusion of HIV Positives Different Exclusion N Mean SD t-value LS Social Exclusion Self exclusion When the feeling of exclusion was studied only150 of the respondents felt either socially excluded or themselves go for secluding themselves the rest (59) do not feel the sense of different kind of exculsion which is not put to t test. It is clear from the table that the calculated t-value (3.14) which is significant at 1% level. Hence the stated hypothesis is accepted. So social exclusion and self exclusion differ among the respondents. They are independent of each other. It makes one to confirm that majority of the HIV positive persons fall a pray to high level of stress which would hinder their medications and sociability. A study conducted by Clayton, A. and MC. Queen, C. say that in African American HIV positive individual indicate that the stigma associated with HIV infection increase depression in them. Social exclusion and Self exclusion are not mutually inclusive but exclusive. Any sort of exclusion might lead to depression. Age group Table No 3 Age And Level Of Depression DEPRESSION LEVEL >50 years x 2 Value; Significant Level 8.011; p<0.05 In this section, an attempt is made to analyse and interpret selected socio-demographic of the PLWHAs across their level of depression. Age-wise distribution of the PLWHAs showed that, in the total universe, about 35 per cent are in the age group of years, 31 per cent of them belong to the age group of years, more than one fourth percent of them are belong to the age group of years and rest of then are in the age group of above 50 years. The share of severe level of depression is little greater in the age group of years as compared to other age groups. It is unfortunate to find that 45.5% of the respondents belonging to the age group of years are with severe level of depression. The other dominant age group severe having depression is years of age. Incase of moderate level of depression we find that the upper adult age group (41-50 years) are found to have (51%) higher sufferings than any other age group of respondents. Open Access Journals Blue Ocean Research Journals 234

4 Educational Qualification Table No 4 Educational Qualification And Level Of Depression LEVEL OF DEPRESSION Illiterate School level Degree x 2 Value; Significant Level ; p<0.001 With regards to educational qualification of the PLWHAs, among the total sample, as high as 50 per cent are illiterates,47 per cent of them are having school level education whereas just 3per cent of them are degree holders.. Across their level of depression, it can be noted that illiterates are in majority among those who are having minimum level of depression than those who are having school level education and degree holders. Whereas the reverse pattern is noticed in the case of severe and moderate level of depression which is higher among the school level educated than the illiterates and degree holders. Again the mild level of depression is higher in case of illiterates. Further, these percentage differentials are turned out to be highly significant (Chisquare=16.578; p<0.001). The interference is that the higher the level of education lesser will be the depression among the HIV positive people. The other understanding is that the educated has better understanding of their ailments and there by they do not get in to depression. MARITAL STATUS Table No 5 Marital Status And Level Of Depression LEVEL OF DEPRESSION Single Married Widow Divorced Separated x 2 Value; Significant Level 8.011; p<0.05 From the above table the researcher came to know that among the total respondents nearly 50 per cent of them are married and more than one fifth of the respondents are widows,15.3 percent of the respondents are divorced, less than 14 per cent of the respondents are single and the remaining are separated. Across the level of depression more than 52 per cent of the married are having minimum level depression at a higher rate. Again moderate and severe level of depression is found to be high among the married than others. So it very clear that depression is very much associated with marriage. It is also found that those who remain as single are having low level of depression when compared to other category of the respondents. The same way the separated also do not suffer much from depression based on their infection. Suggestions: The HIV positives should be given counselling in a professional way in the positive centers by appointing trained social workers. Other than counseling giving meditation,physical exercises to the registered HIV positives in the positive centers will help them to have lesser level of depression. In addition to that the Voluntary Counselling and Testing Centre (VCTC) and Integrated Counseling and Testing Centre (ICTC) centers should involve in confidence building exercises through social networking of the HIV positive persons, which will help them to have reduced level of depression. Once their level of depression is diluted in the base level that would prevent having behavioral changes of HIV positives in an effective way. Conclusion: It is evident that the HIV positives are not only affected by biological ailments and severe deterioration in their health status. The people living with HIV Aids are destined to suffer from milder depression to severe level of depression. The research brings home that the depression level gets differed with the level of either the social exclusion or self exclusion. The longevity of sufferings from the human immune virus makes the higher age group of the respondents to succumb to severe level of Open Access Journals Blue Ocean Research Journals 235

5 depression. The societal and cultural expectations and demands do not spare the married HIV positives to escape from different level of depressions. It is suggested that as soon as some one is identified to be positive with HIV, he or she has to be sensitised with the impact of the virus and prepare their mind to accept their predicament and try to face the challenges associated with this. This could be more professionally handled by trained social workers. It is a predisposed condition to appoints trained social workers in all such government and private centers where these HIV positives are helped. This would inturn reduce the depression of already ailing people from aggravating their sufferings. References [1] Andriote,J.M HIV Mental Health Treatment Issues. HIV and Clinical Depression. Rong? hw.tma chec=true D8.10/1/2014, Accessed on 10 th Nov [2] Basavaraj, KH., Navya, M.A. and Kashm, R. Mysore Quality of life in HIV/AIDS. Indian Journal of sexually Transmitted Disease and AIDS, Vol 31 No 5 (p-.5) [3] Chandra.A.S, Desai,G. and Ranjan,S.HIV & Psychiatric Disorders. Indian Journal of Medical Research, 2005, April 121(4) [4] Gov. Office on Women's Health, Mental Health and HIV/AIDS (Depression), U. S. Department of Health and Service [5] National Institute of Mental Health, Depression and HIV/AIDS. Depression and Bipolar Support Alliance. Chicago. NIH Publication 2011, No [6] National Institute of Mental Health. NIH Publication No Revised [7] Palella, Jr, et al., The role of social support and psychological resources in depression in people living with HIV/aids: examine the mediating role of mastery and self-esteem Clinical Science, Vol.10, issue [8] Shittu,R.O. et al, Family Dysfunction Among Depressed HIV/AIDS patients on HAART, in a secondary health institution, in north central Nigeria, HIV & AIDS Review (2014) Accessed on 20.Jan [9] Urison, A. HIV and Depression file%20library/ practice hiv/fact%20sheets/depression-2012.pdf. Accessed on 25 June Open Access Journals Blue Ocean Research Journals 236