AIDS and Behavior

, Volume 21, Issue 6, pp 1511–1517 | Cite as

The Prevalence of Common Mental Disorders Among South Africans Seeking HIV Testing

  • Ashraf KageeEmail author
  • Wylene Saal
  • Laing De Villiers
  • Mpho Sefatsa
  • Jason Bantjes
Original Paper


We administered the Structured Clinical Interview for the DSM to 485 persons seeking HIV testing at five community testing centres in South Africa to determine the prevalence of common mental disorders among this population. The prevalence estimates for the various disorders were as follows: major depressive disorder: 14.2 % (95 % CI [11.1, 17.3]); generalised anxiety disorder 5.0 % (95 % CI [3.07, 6.93]); posttraumatic stress disorder 4.9 % (95 % CI [2.98, 6.82]); and alcohol use disorder 19.8 % (95 % CI [16.26, 23.34]). Our findings imply the need to research the integration of screening and referral trajectories in the context of voluntary HIV counselling and testing.


Mental disorders South Africa Depression Anxiety Post-traumatic stress 



This study was funded by the National Research Foundation in South Africa (Grant Number 93515).

Compliance with Ethical Standards

Conflict of interest

The authors have no potential conflicts of interest.

Human and Animals Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Pence BW, Miller WC, Gaynes BN, Eron JJ Jr. Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2007;44(2):159–66. doi: 10.1097/QAI.0b013e31802c2f51.CrossRefPubMedGoogle Scholar
  2. 2.
    Ramirez-Avila L, Regan S, Giddy J, Chetty S, Ross D, Katz JN, Bassett IV. Depressive symptoms and their impact on health-seeking behaviors in newly-diagnosed HIV-infected patients in Durban, South Africa. AIDS Behav. 2012;16(8):2226–35.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Cholera R, Gaynes BN, Pence BW, Bassett J, Qangule N, Macphail C, Miller WC. Validity of the patient health questionnaire-9 to screen for depression in a high-HIV burden primary healthcare clinic in Johannesburg, South Africa. J Affect Disord. 2014;167:160–6.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Med Care. 1991;29(2):169–76.CrossRefPubMedGoogle Scholar
  5. 5.
    Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry, 1998;59 Suppl 20:22–33; quiz 34–57.Google Scholar
  6. 6.
    Herman AA, Stein DJ, Seedat S, Heeringa SG, Moomal H, Williams DR. The South African Stress and Health (SASH) study: 12-month and lifetime prevalence of common mental disorders. S Afr Med J. 2009;99:339–44.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Freeman M. HIV in developing countries: heading towards a mental health and consequent social disaster? S Afr J Psychol. 2004;34:139–59. doi: 10.1177/008124630403400109.Google Scholar
  8. 8.
    Els C, Boshoff W, Scott C, Strydom W, Joubert G, van der Ryst E. Psychiatric morbidity in South African HIV/AIDS patients. S Afr Med J. 1999;89:992–5.Google Scholar
  9. 9.
    Olley B, Seedat S, Stein DJ. Persistence of psychiatric disorders in a cohort of HIV/AIDS patients in South Africa: a 6-month follow-up study. J Psychosom Res. 2006;61:479–84. doi: 10.1016/j.jpsychores.2006.03.010.CrossRefPubMedGoogle Scholar
  10. 10.
    Berger-Greenstein JA, Cuevas CA, Brady SM, Trezza G, Richardson MA, Keane TM. Major depression in patients with HIV/AIDS and substance abuse. AIDS Patient Care STDs. 2007;21:942–55. doi: 10.1089/apc.2006.0153.CrossRefPubMedGoogle Scholar
  11. 11.
    Remien RH, Exner T, Kertzner RM, Ehrhardt AA, Rotheram-Borus MJ, Johnson M, Kelly JA. Depressive symptomatology among HIV-positive women in the era of HAART: a stress and coping model. Am J Commun Psychol. 2006;38:275–85. doi: 10.1007/s10464-006-9083-y.CrossRefGoogle Scholar
  12. 12.
    Olley BO, Gxamza F, Seedat S, Theron H, Taljaard J, Reid J, Stein DJ. Psychopathology and coping in recently diagnosed HIV/AIDS patients—the role of gender. S Afr Med J. 2003;93:928–31.PubMedGoogle Scholar
  13. 13.
    Hughes J, Jelsma J, Maclean E, Darder M, Tinise X. The health-related quality of life of people living with HIV/AIDS. Disabil Rehabil. 2004;26:371–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Myer L, Smit J, Roux LL, Parker S, Stein DJ, Seedat S. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STDs. 2008;22:147–58. doi: 10.1089/apc.2007.0102.CrossRefPubMedGoogle Scholar
  15. 15.
    Freeman M, Nkomo N, Kafaar, Kelly K. Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa. AIDS Care. 2007;19:1201–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Collins PY, Holman AR, Freeman MC, Patel V. What is the relevance of mental health to HIV/AIDS care and treatment programs in developing countries? A systematic review. AIDS. 2006;20:1571. doi: 10.1097/01.aids.0000238402.70379.d4.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Rabkin JGHIV. HIV and depression: 2008 review and update. Curr HIV/AIDS Rep. 2008;5:163–71.CrossRefPubMedGoogle Scholar
  18. 18.
    Kagee A. Application of the DSM-IV criteria to the experience of living with AIDS: some concerns. J Health Psychol. 2008;13:34–7. doi: 10.1177/1359105308097964.Google Scholar
  19. 19.
    Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, De Graaf R, Vollebergh W, Wittchen HU. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. Int J Methods Psychiatric Res. 2003;12:3–21. doi: 10.1002/mpr.138.CrossRefGoogle Scholar
  20. 20.
    Kagee A. Adherence to antiretroviral therapy in the context of the national roll-out in South Africa: defining a research agenda for psychology. S Afr J Psychol. 2008;38:413–28.Google Scholar
  21. 21.
    Simbayi LC, Kalichman SC, Strebel A, Cloete A, Henda N, Mqeketo A. Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sex Transm Infect. 2007;83:29–34. doi: 10.1136/sti.2006.019893.CrossRefPubMedGoogle Scholar
  22. 22.
    Turan JM, Bukusi EA, Onono M, Holzemer WL, Miller S, Cohen CR. HIV/AIDS stigma and refusal of HIV testing among pregnant women in rural Kenya: results from the MAMAS study. AIDS Behav. 2011;15:1111–20. doi: 10.1007/s10461-010-9798-5.CrossRefPubMedGoogle Scholar
  23. 23.
    Wood SA, Tobias C. Barriers to care and unmet needs for HIV-positive women caring for children perceptions of women and providers. J HIV/AIDS Soc Serv. 2005;3:47–65. doi: 10.1300/J187v03n02_04.CrossRefGoogle Scholar
  24. 24.
    Coetzee B, Kagee A, Vermeulen N. Structural barriers to adherence to antiretroviral therapy in a resource-constrained setting. The perspectives of health care providers. AIDS Care. 2011;23:146–51. doi: 10.1080/09540121.2010.498874.CrossRefPubMedGoogle Scholar
  25. 25.
    Coetzee B, Kagee A. The development of an inventory to assess the structural barriers to clinic attendance and pill-taking amongst persons enrolled on antiretroviral therapy (ART). AIDS Behav. 2013;17:319–28. doi: 10.1007/s10461-012-0374-z.CrossRefPubMedGoogle Scholar
  26. 26.
    Kagee A, Steele H, Coetzee B. The relationship between structural barriers to adherence to antiretroviral therapy, psychological distress, and health-related quality of life. S Afr J Psychol. 2014;44:170–9. doi: 10.1177/0081246313518329.Google Scholar
  27. 27.
    Kagee A, Nothling J, Coetzee B. The perspectives ART users of structural barriers to antiretroviral therapy adherence in South Africa. S Afr Fam Pract. 2012;54:540–4. doi: 10.1080/20786204.2012.10874289.CrossRefGoogle Scholar
  28. 28.
    Kagee A, Delport T. Barriers to adherence to antiretroviral treatment: the perspectives of patient advocates. J Health Psychol. 2010;15:1001–11. doi: 10.1177/1359105310378180.CrossRefPubMedGoogle Scholar
  29. 29.
    Kagee A, Tsai A, Lund C, Tomlinson M. Screening for common mental disorders in low resource settings: reasons for caution and a way forward. Int Health. 2013;5:11–4. doi: 10.1093/inthealth/ihs004.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Ashraf Kagee
    • 1
    Email author
  • Wylene Saal
    • 1
  • Laing De Villiers
    • 1
  • Mpho Sefatsa
    • 1
  • Jason Bantjes
    • 1
  1. 1.Stellenbosch UniversityStellenboschSouth Africa

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