TITLE:
Prevalence and Factors Associated with Risky Sexual Behaviors among Patients with Severe Mental Illness in Uganda: A Descriptive Cross Sectional Study
AUTHORS:
Caroline Birungi, Wilber Ssembajjwe, Noah Kiwanuka, Noeline Nakasujja, Eugene Kinyanda
KEYWORDS:
Risky Sexual Behaviour, Severe Mental Illness, Adults, Uganda
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.12 No.2,
April
24,
2022
ABSTRACT: Background: Persons living with
severe mental illness (SMI) which includes schizophrenia, bipolar affective
disorder and recurrent major depressive disorder are predisposed to risky
sexual behavior (RSB). There is a paucity of data on this problem in
sub-Saharan Africa and where research has been undertaken, only a limited range
of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence
the need for this study. The objective of this study was to determine the
prevalence and factors associated with risky sexual behavior among individuals
with SMI attending care in central and south western Uganda. Methods: A
cross sectional study was conducted among 393 persons with SMI attending two
psychiatric out-patient facilities in Uganda. Psychiatric disorder was
confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB
was defined as engaging in at least one of four risky sexual behaviours that
have been associated with HIV infection in the Ugandan psychosocial environment
in the last three months using an 8 item RSB questionnaire used for assessment
of RSB. Prevalence of RSB and associated correlates were determined using
multiple logistic regression. Results: The Prevalence of RSB in last 3
months’ periods was 24.2% (95% CI: 20.2% -
28.7%). The factors that were independently significantly associated with RSB
were: trauma related (history of childhood trauma, past and current sexual
abuse, past and current physical abuse) current psychosocial challenges (mental
health stigma) and psychiatric illness factors (history of a past manic
episode, current psychotic episode, severity of depressive symptoms and
severity of manic symptoms). Conclusions: One quarter of clinic
attending respondents with severe mental illness in Uganda practice risky sexual behaviour. Factors associated
with risky sexual behaviour fall under the domains of past and present trauma,
current psychosocial challenges and psychiatric illness factors. This
calls for a multi-sectoral approach that includes community awareness about the
nature of SMI and the rights of persons with SMI and measures to improve
Psychiatric symptom management.