Perceptions of risky sexual behaviour among individuals with severe mental illness in Uganda

Volume 6, Issue 6, December 2022     |     PP. 403-417      |     PDF (209 K)    |     Pub. Date: December 11, 2022
DOI: 10.54647/sociology84947    91 Downloads     5431 Views  

Author(s)

C. Birungi, Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda
W. Ssembajjwe, Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Entebbe, Uganda; Statistical and Data Management Section, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
N Kiwanuka, Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
E. Kinyanda, Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda; Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Entebbe, Uganda
N. Nakasujja, Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda

Abstract
Objectives
To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental illness(SMI) in Uganda.
Hypothesis
Participants who perceive themselves as being at a high risk for RSB have a higher perception to RSB.
Research question
What is the perception of RSB among individuals with SMI?
Methods
This was a cross sectional study among patients with severe mental illness at a tertiary(Urban) and a secondary(Rural) hospitals. Consecutive patients were randomly included in the study and interviewed about their perceptions to RSB, socio-demographic, psychiatric illness, psychosocial environment on RSB. Individuals who were ill and unable to participate in the study. The outcome was perception to RSB. We used linear regression to ascertain the factors associated with RSB among people with SMI.The data was analyzed using STATA version 15.0 software and statistical significance was determined at a p-value <0.05
Results
We enrolled 480 into the study, females (n = 211, 53.4%) and unmarried (68.1%, n = 267). the median age was 36 years, majority were unemployed (46.9%), single (38.2%) with formal education (80. 4%). There was a high perception to RSB among the young, p = 0.003, (β=-0.12, 95% CI: -0.19; -0.04), those with mental health stigma p<0.001 (β = 0.30, 95% CI: 0.20–0.40), having past sexual abuse p = 0.016, (β= 2.26,95% CI: 0.42-4.10), a current and past depressive episode, p = 0.046, (β= 1.56,95% CI: 1.99-5.95, 0.03;3.09) and a past manic episode, p= 0.006, (β=2.28, = 95% CI:0.67-3.89).
Conclusions
Individuals with SMI in this mentally stable cohort had an increased perception to RSB. This may predispose them to RSB most especially being young, having a current, past depressive episode and a current manic episode. Health care providers should assess for RSB especially among patients with mood disorders.

Keywords
perception, risky sexual behavior, severe mental illness, adults, Uganda

Cite this paper
C. Birungi, W. Ssembajjwe, N Kiwanuka, E. Kinyanda, N. Nakasujja, Perceptions of risky sexual behaviour among individuals with severe mental illness in Uganda , SCIREA Journal of Sociology. Volume 6, Issue 6, December 2022 | PP. 403-417. 10.54647/sociology84947

References

[ 1 ] Lundberg P, Johansson E, Okello E, et al. Sexual risk behaviours and sexual abuse in persons with severe mental illness in Uganda: a qualitative study. PloS one. 2012;7(1):e29748.
[ 2 ] Cert P, MHN GD. The sexual health and relationship needs of people with severe mental illness.
[ 3 ] Akwara PA, Madise NJ, Hinde A. Perception of risk of HIV/AIDS and sexual behaviour in Kenya. Journal of biosocial science. 2003;35(3):385-411.
[ 4 ] Control CfD, Prevention. Revised guidelines for HIV counseling, testing, and referral. MMWR Recommendations and reports: Morbidity and mortality weekly report Recommendations and reports. 2001;50(RR-19):1-19a1.
[ 5 ] Prohaska TR, Albrecht G, Levy JA, et al. Determinants of self-perceived risk for AIDS. Journal of Health and Social behavior. 1990:384-94.
[ 6 ] Torres I, DeFreitas C, DeFreitas V, et al. Relationship between cognitive functioning and 6-month clinical and functional outcome in patients with first manic episode bipolar I disorder. Psychological medicine. 2011;41(5):971-82.
[ 7 ] Sheehan D, Lecrubier Y, Janavs J, et al. Mini International Neuropsychiatric Interview English version 7.0. 2 for DSM-5. University of South Florida College of Medicine. 2016.
[ 8 ] Lundberg P, Nakasujja N, Musisi S, et al. HIV prevalence in persons with severe mental illness in Uganda: a cross-sectional hospital-based study. International journal of mental health systems. 2013;7(1):1-9.
[ 9 ] Yakasai B. Neuropsychiatric complications of HIV/AIDS. Annals of African Medicine. 2004;3(2):63-5.
[ 10 ] Watkins CC, Treisman GJ. Neuropsychiatric complications of aging with HIV. Journal of neurovirology. 2012;18(4):277-90.
[ 11 ] Chanakira E, O’Cathain A, Goyder EC, et al. Factors perceived to influence risky sexual behaviours among university students in the United Kingdom: a qualitative telephone interview study. BMC public health. 2014;14(1):1-7.
[ 12 ] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. ed t, editor. Arlington, VA: American Psychiatric Publishing 2013.
[ 13 ] Fink B. Childhood Trauma Questionnaire: A retrospective self-report manual. San Antonia TX: The Psychological Corporation; 1998.
[ 14 ] Kinyanda E, Nakasujja N, Levin J, et al. Major depressive disorder and suicidality in early HIV infection and its association with risk factors and negative outcomes as seen in semi-urban and rural Uganda. Journal of affective disorders. 2017;212:117-27.
[ 15 ] Zimet GD, Powell SS, Farley GK, et al. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. Journal of personality assessment. 1990;55(3-4):610-7.
[ 16 ] Kerkhof A, Arensman E. Repetition of Attempted Suicide: Frequent, but Hard to Predict. Suicidal behaviour: Theories and research findings. Ashland, OH, US: Hogrefe & Huber Publishers; 2004. p. 111-24.
[ 17 ] Kinyanda E, Hjelmeland H, Musisi S. Negative life events associated with deliberate self-harm in an African population in Uganda. Crisis. 2005;26(1):4-11.
[ 18 ] King M, Dinos S, Shaw J, et al. The Stigma Scale: development of a standardised measure of the stigma of mental illness. The British journal of psychiatry : the journal of mental science. 2007;190:248-54.
[ 19 ] Gonzalez JS, Shreck E, Batchelder A. Hamilton Rating Scale for Depression (HAM-D). In: Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. New York, NY: Springer New York; 2013. p. 887-8.
[ 20 ] Young RC, Biggs JT, Ziegler VE, et al. A rating scale for mania: reliability, validity and sensitivity. The British journal of psychiatry : the journal of mental science. 1978;133:429-35.
[ 21 ] Berendsen S, van der Veen NM, van Tricht MJ, et al. Psychometric properties of the DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity. Schizophrenia research. 2020;216:416-21.
[ 22 ] Kinyanda E, Weiss HA, Mungherera M, et al. Psychiatric disorders and psychosocial correlates of high HIV risk sexual behaviour in war-affected Eastern Uganda. AIDS care. 2012;24(11):1323-32.
[ 23 ] Napper L, Fisher D, Reynolds G. Perceived Risk of HIV Infection Scale (PRHS)(appears in: Development of the Perceived Risk of HIV Scale). Copyright: Creative Commons License. 2012.
[ 24 ] Maughan-Brown B, Venkataramani AS. Accuracy and determinants of perceived HIV risk among young women in South Africa. BMC public health. 2018;18(1):1-9.
[ 25 ] Zurbriggen EL, Freyd JJ. The link between child sexual abuse and risky sexual behavior: The role of dissociative tendencies, information-processing effects, and consensual sex decision mechanisms. 2004.
[ 26 ] Miller M. A model to explain the relationship between sexual abuse and HIV risk among women. AIDS care. 1999;11(1):3-20.
[ 27 ] Leverich GS, McElroy SL, Suppes T, et al. Early physical and sexual abuse associated with an adverse course of bipolar illness. Biological psychiatry. 2002;51(4):288-97.
[ 28 ] McCandless F, Sladen C. Sexual health and women with bipolar disorder. Journal of Advanced Nursing. 2003;44(1):42-8.
[ 29 ] Kelly JA, Murphy DA, Bahr GR, et al. Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychology. 1993;12(3):215.
[ 30 ] Luseno WK, Field SH, Iritani BJ, et al. Pathways to depression and poor quality of life among adolescents in Western Kenya: role of anticipated HIV stigma, HIV risk perception, and sexual behaviors. AIDS and Behavior. 2021;25(5):1423-37.