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The Validity of the Substance Abuse and Mental Illness Symptom Screener (SAMISS) in People Living with HIV/AIDS in Primary HIV Care in Cape Town, South Africa

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Abstract

Given the high prevalence of HIV in South Africa and co-morbid mental disorders in people living with HIV/AIDs (PLWHA) we sought to validate a brief screening tool in primary HIV care. Methods: 366 PLWHA were recruited prior to combination anti-retroviral treatment (CART) initiation from two primary health HIV clinics. A mental health nurse administered a socio-demographic questionnaire and the Mini Neuropsychiatric Interview (MINI) and a lay counsellor administered the Substance and Mental Illness Symptom Screener (SAMISS). Results: Using the MINI, 17 % of participants were identified with either depression, anxiety disorders or adjustment disorder and 18 % with substance or alcohol abuse/dependence. The sensitivity and specificity of the SAMISS was 94 % (95 % CI: 88–98 %) and 58 % (95 % CI: 52–65 %) respectively, with the alcohol component (sensitivity: 94 %; specificity: 85 %) performing better than the mental illness component of the SAMISS (sensitivity: 97 %; specificity: 60 %). The specificity of the tool improved when the cut-off for the mental illness component was increased. Conclusion: The SAMISS may provide a useful first tier screening tool for common mental disorders in primary care for PLWHA.

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Acknowledgments

We would like to thank Dr Karen Jennings and the Health Management Team of the City of Cape Town for their support for this study. In particular, we would like to thank Sr Yoliswa Mtingeni, Mrs Kareema Poggenpoel, the counsellors and staff at Langa and Crossroads CHC and the study participants for their contributions to this study. The work conducted in collecting data for this paper was funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), through USAID under the terms of Award no. 674-A-00-08-00009-00 to the Anova Health Institute. EB is funded by a grant from UK aid from the UK Government. DS is funded by the Medical Research Council of South Africa. The opinions expressed in this article are not necessarily those of the funders.

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Authors and Affiliations

  1. Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Rd, Rondebosch, Cape Town, 7700, South Africa

    Erica Breuer, Kevin Stoloff & John A. Joska

  2. Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa

    Landon Myer & Dan J. Stein

  3. Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa

    Soraya Seedat

  4. Medical Research Council of South Africa, Cape Town, South Africa

    Soraya Seedat

Authors
  1. Erica Breuer
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  2. Kevin Stoloff
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  3. Landon Myer
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  4. Soraya Seedat
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  5. Dan J. Stein
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  6. John A. Joska
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Correspondence to Erica Breuer.

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Breuer, E., Stoloff, K., Myer, L. et al. The Validity of the Substance Abuse and Mental Illness Symptom Screener (SAMISS) in People Living with HIV/AIDS in Primary HIV Care in Cape Town, South Africa. AIDS Behav 18, 1133–1141 (2014). https://doi.org/10.1007/s10461-014-0698-y

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