Perceptions of mental illness among HIV counselors in Uganda : a qualitative study

[摘要] ENGLISH ABSTRACT: The HIV/AIDS pandemic has led to millions of deaths; disability for the sufferers and multiple socioeconomiceffects on HIV infected and affected individuals. Among the factors affecting people livingwith HIV/AIDS that may contribute to HIV related disability is mental illness such as HIV related maniasand depression. 'HIV counselors' make up part of the team at the forefront of HIV treatment andmanagement in Uganda but little is known about their perceptions of mental illness. This study thereforesought to explore the perceptions of mental illness among HIV counselors in Uganda. A qualitative studywas conducted. Ten individual interviews and three focus group discussions were carried out among 31HIV counselors. They were selected from five HIV treatment centers in Kampala district, Uganda. Aninterview guide based on Kleinman's explanatory model of illness with case vignettes depictingdepression, alcohol abuse, mania, and psychosis were used to facilitate discussion. Data was thematicallyanalyzed. HIV counselors exhibited some knowledge concerning depression among HIV positive clients,with some viewing the symptoms of depression as 'understandable sadness arising from the HIV client'spsychosocial reality which is rife with poverty, stigma and lack of social support. Counselors alsoreported that some of their client's physical symptoms were a result of their emotional problems. Maniaand psychosis were attributed to religious beliefs and witchcraft; and in some cases disease progression orHIV drugs. Chronic alcohol abuse, despite continuous counseling was seen as a waste of the counselor'stime in face of overwhelming numbers of clients per day. Such clients, along with clients with suicidalideations were often threatened or ignored. Counselors agreed that they needed training on assessment ofmental illness, and how difficult cases could be referred.

[发布机构] Stellenbosch University