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Open Access Research article

Poor mental health and sexual risk behaviours in Uganda: A cross-sectional population-based study

Patric Lundberg12*, Godfrey Rukundo3, Schola Ashaba3, Anna Thorson4, Peter Allebeck1, Per-Olof Östergren2 and Elizabeth Cantor-Graae2

Author Affiliations

1 Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden

2 Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden

3 Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda

4 Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden

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BMC Public Health 2011, 11:125  doi:10.1186/1471-2458-11-125

Published: 21 February 2011

Abstract

Background

Poor mental health predicts sexual risk behaviours in high-income countries, but little is known about this association in low-income settings in sub-Saharan Africa where HIV is prevalent. This study investigated whether depression, psychological distress and alcohol use are associated with sexual risk behaviours in young Ugandan adults.

Method

Household sampling was performed in two Ugandan districts, with 646 men and women aged 18-30 years recruited. Hopkins Symptoms Checklist-25 was used to assess the presence of depression and psychological distress. Alcohol use was assessed using a question about self-reported heavy-episodic drinking. Information on sexual risk behaviour was obtained concerning number of lifetime sexual partners, ongoing concurrent sexual relationships and condom use.

Results

Depression was associated with a greater number of lifetime partners and with having concurrent partners among women. Psychological distress was associated with a greater number of lifetime partners in both men and women and was marginally associated (p = 0.05) with having concurrent partners among women. Psychological distress was associated with inconsistent condom use among men. Alcohol use was associated with a greater number of lifetime partners and with having concurrent partners in both men and women, with particularly strong associations for both outcome measures found among women.

Conclusion

Poor mental health is associated with sexual risk behaviours in a low-income sub-Saharan African setting. HIV preventive interventions should consider including mental health and alcohol use reduction components into their intervention packages, in settings where depression, psychological distress and alcohol use are common.