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Open Access Research article

Prevalence and factors associated with probable HIV dementia in an African population: A cross-sectional study of an HIV/AIDS clinic population

Juliet Nakku1*, Eugene Kinyanda2 and Susan Hoskins3

Author Affiliations

1 Makerere University College of Health Sciences/Butabika National ReferralĀ /Teaching Hospital, P.O.Box 24136 Kampala, Uganda

2 MRC/UVRI Uganda Research Unit on AIDS & Senior EDCTP Fellowship, Kampala, Uganda

3 MRC Clinical Trials Unit, London, UK

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BMC Psychiatry 2013, 13:126  doi:10.1186/1471-244X-13-126

Published: 3 May 2013

Abstract

Background

The HIV/AIDS infection is common in sub-Saharan Africa and is associated with psychological and neuro- cognitive impairment. These conditions, however, remain largely unrecognized. In this study we aimed to determine the prevalence of probable HIV dementia (PHD) in an HIV clinic population in Uganda and to delineate the factors associated with such impairment in these HIV positive individuals.

Methods

Six hundred eighty HIV clinic attendees were surveyed in a cross sectional study. PHD was assessed using the International Dementia Scale (IHDS). Standardized measures were also used to assess clinical, psychological, social and demographic variables. Respondents were aged 18 years and above and did not have severe physical or mental health conditions. Multivariate analysis was conducted to identify associations between PHD and various factors.

Results

The prevalence of probable HIV dementia was 64.4%. PHD was significantly associated with increasing stress scores and psychosocial impairment but not with age, BMI, CD4 count, use of HAART, or a diagnosis of depression or alcohol dependence.

Conclusion

The prevalence of probable HIV dementia in an ambulatory adult HIV positive population in Uganda was 64.4%. Increasing stress scores and psychosocial impairment were significant contributing factors. Clinicians need to be aware of this and to make efforts to identify neuro-cognitive impairment. Secondly there is need for more studies to better understand the relationship between PHD and stress in HIV populations so as to inform patient care.

Keywords:
HIV dementia; Neuro-cognitive impairment; HIV/AIDS; HIV dementia; Stress; Africa