SOCIOECONOMIC AND PSYCHIATRIC ASPECTS OF HIV INFECTED PATIENTS IN AN URBAN BRAZILIAN POPULATION: A CROSS-SECTIONAL STUDY
Resumo
Introduction: Depression is the most common psychiatric disorder among people living with HIV (PLHIV) and impairs adherence to highly active antiretroviral therapy (HAART) and worsen the prognosis of HIV infection. Objectives: This study assessed the association between depressive symptoms, quality of life, socioeconomic and demographic factors in patients newly diagnosed with HIV / AIDS. Methods: This is a cross-sectional study, we evaluated 59 patients using the Beck Depression Inventory (BDI) and the WHOQOL-HIV-Bref. Results: The prevalence of severe depressive symptoms (BDI? 20) was 28,81%. In the depressive group there was predominance of cognitive and affective symptoms and not of somatic complaints as might be expected by a chronic infectious disease like HIV. There was a positive association between depressive symptoms, low income and low social class. Worse quality of life was related to depression, poor education and low income. Discussion: These results suggest that poverty and poor educational level may be moderating depression risk among PLHIV. This is an alarming fact, considering that HIV infection is showing a tendency towards empoverishment. Poverty and poor education are related to less acess to adequate information, less social and financial support, higher risk of executive dysfunction and less effective cognitive coping strategies. Furthermore, social adversity in childhood can induce long term neuroimmune and neuroendocrine changes, which may predispose to psychiatric disorders in adulthood. Conclusion: Though Brazil has developed a special public health system to assist PLHIV, the present results indicate a need of psychosocial interventions designed to increase information, social support, strength, self-confidence and coping strategies among PLHIV.