Introduction: Depression is common in HIV/AIDS. We aim to investigate the frequency and the grade of this mental disorder in partners and determine its influence on sexual dysfunctions in serodiscordant couples in Ouagadougou. Patients/Method: This cross-sectional study was monitored from 1 January to 31 June 2010 in the internal medicine department of CHUYO, Ouagadougou. HIV-infected patients and their seronegative partners who gave their consent were included. Depression was diagnosed using the Beck Depression Inventory 13 items (BDI-13). Results: Eighty heterosexual and monogamous serodiscordant couples were studied. 31 (38.7%) HIV-infected and 23 (28.7%) seronegative partners were affected by depression; p = 0.18. The score of depression was 3.5 ± 2.1 in HIV-infected and 3.3 ± 1.6 in seronegative partners; p = 0.85. Depression was diagnosed in both partners in 13 couples (16.2%) and in only one partner in 28 couples (35%). Depression was diagnosed at least for one partner in 40 (51.3%) couples where sexual dysfunctions affected partner (s) and in 1 (50%) couple where no sexual dysfunction was reported. Conclusion: Psychological assessment is needed for a better management of HIV/AIDS in serodiscordant couples.
Publications dedicated to depression in HIV-infected patients report a prevalence of depressive symptoms ranging from 21% to 97% [
It was a cross sectional study, monitored from 1 January to 30 June 2010 in the day care hospital, in the internal medicine department, a tertiary HIV care referral center, CHUYO, Ouagadougou.
HIV-infected patients who were followed in the day care hospital and their seronegative partners were the study’s population. Couples were included in this study if the two partners gave their consent to participate, and if the HIV-negative partner was already aware of the HIV status of the HIV-positive partner. Couples in which one or both partners were not able to undergo the questionnaire were not included. Patients were approached during a follow-up consultation in order to explain the objectives of the study. The number of couples included in the study was subjected to the duration of the study period and has not been determined by statistical calculations.
Data were collected using a questionnaire delivered to the partners separately and then together by the same investigator. Patient’s socio-demographic characteristics, data related to serodiscordance, depressive symptoms and sexual dysfunctions were reported in the questionnaire.
Depression was diagnosed using the French version of Beck Depression Inventory 13 items (BDI-13) [
The institutional committee has approved the study. Patient’s consent was obtained, and data’s confidentiality has been monitored during the study.
Data were analyzed using Epi Info version 3.5.2. The Chi square or Fischer statistical tests and the Student’s test were used to compare respectively the qualitative and quantitative variables. Statistical differences were considered significant for p < 0.05.
Eighty heterosexual and monogamous serodiscordant couples have been studied. The woman was the HIV-infected
| Symptoms | Frequency | % |
|---|---|---|
| Fatigability | 12 | (22.2) |
| Difficulty at work | 20 | (37) |
| Negative self-image | 32 | (59.2) |
| Failed staff | 12 | (22.2) |
| Indecision | 10 | (18.5) |
| Dissatisfaction | 10 | (18.5) |
| Anorexia | 06 | (11.1) |
| Pessimism | 09 | (16.7) |
| Guilt | 45 | (83.3) |
| Sadness | 40 | (74.1) |
| Social withdrawal | 05 | (9.2) |
| Self-loathing | 38 | (70.4) |
| Suicidal ideation | 00 | (0%) |
partner in 60 couples (75%). The average age was 37.5 years (limits: 20 and 62) for HIV-infected and 40 years (limits: 23 and 65) for seronegative partners; p = 0.08. The average age was 35 years (limits: 18 and 60) for women and 40 (limits: 25 and 65) for men; p = 0.01. The partners were married in 67 couples (83.7%) and cohabiting in 13 couples (16.3%) since 10 ± 4 years (limits: 1 and 35). The serodiscordance status was known for 4 ± 1 years (limits: 1 and 12). In 41 couples (51.2%), the partners were illiterate while in the 39 remaining (48.8%), at least one partner was educated.
Fifty four (33.7%) cases of depression were observed. According to HIV status, depression was diagnosed in 31 (38.7%) HIV-infected and 23 (28.7%) seronegative partners; p = 0.18. According to the gender, depression was diagnosed in 29 (36.2%) women and 25 (31.2%) men; p = 0.50. Depression was diagnosed in both partners in 13 couples (16.2%), one partner in 28 couples (35%) and none partner in 39 couples (48.8%).
In 78 (97.5%) couples, at least one partner reported sexual dysfunction. Disturbances of libido, erection and orgasm were reported respectively in 37.2%, 20.5% and 7.7%. In 40 (51.3%) couples where sexual dysfunctions were reported by partner (s), depression was observed in at least one of them, while in 1 (50%) couple where no partner had a sexual dysfunction, depression was diagnosed in one partner; p = 0.11.
In our cohort of serodiscordant couples, no statistic difference was observed in the prevalence and the grade of depression in HIV-infected compared to their seronegative partners. The prevalence of depression in HIV-infected partners meets the proportions of 21% - 97% reported in the literature [
The frequency and the grade of depression did not significantly differ in partners, probably, because, seronegative partners could be just like their infected partners, victims of suffering related to the presence of HIV in the household. The fear of contamination and the uncertainty about the future without the partner could explain their predisposition for depression. Similarly, stigma significantly associated with depression among HIV-infected patients [
No severe depression was registered in partners from our serodiscordant couples. In publications concerning specifically HIV-infected patients, moderate to severe depression was reported in 51.3% in Burkina Faso [
Guilt, sadness, self-loathing and negative considerations of self-image were the most depressive symptoms mentioned by partners. No suicidal ideation was reported, contrarily to proportions ranging from 9% to 12% in Botswana [
Sexual dysfunctions in the couples were not significantly correlated with the presence of depression in partners. This finding seems paradoxical, compared to what commonly reported in the literature [
Depression was assessed in partners of serodiscordant couples with the French version of BDI-13. There was no significant difference in the frequency or the severity of depression in partners. The non-self-administration of the questionnaire was the main methodological limitation. Then, depression is common in HIV-infected and their seronegative partners living in serodiscordant couples, but often goes unnoticed. This disorder must be actively tracked in order to provide an early medical and psychological care and support. Such an approach is needed to promote a global care of HIV and safety sexuality in serodiscordant couples.
The authors report no conflicts of interest in relation with the subject.
OumarGuira,HervéTiéno,YempabouSagna,IsmaelDiallo,SafyatouSawadogo,Joseph Y.Drabo, (2016) Depression in HIV-Infected Compared to Their Seronegative Partners in Serodiscordant Couples in Ouagadougou (Burkina Faso). Open Journal of Internal Medicine,06,15-19. doi: 10.4236/ojim.2016.61004