Does HIV matter when you are poor and how?

René Brandt's PhD thesis on the psychological adjustment of HIV-positive mothers suggests that living with a positive diagnosis adds to the mental health burden of women living in poor communities.

Brandt's study, titled Does HIV Matter When You are Poor and How? The impact of HIV/AIDS on the psychological adjustment of South African mothers in the era of HAART (Highly Active Antiretroviral Therapy: the current form of ARVs being used in South Africa), is a precious contribution to the scant research available on the mental health of HIV-infected women living in sub-Saharan Africa.

A group of 180 women participated in the study. HIV-positive women who were not on ARVS were compared with those who had recently started treatment and those who had been on ARVs for six months, and all three groups were compared with a group of HIV-negative women living in the same community.

Brandt found that HIV-positive women were three times as likely as HIV-negative women to experience high levels of depression. This number increased to four times for those who were not on ARVs. However, her research showed that longer-term use of ARVs can significantly improve HIV-positive women's psychological adjustment even if they remain at greater risk than non-infected women.

Also, depression was more likely in women who used avoidant coping strategies (activities that keep them from facing stressful events), perceived their physical health as poor and lived in households with an irregular income. Poverty was in fact as likely to be associated with depression as living with a positive diagnosis.

Brandt has just been awarded a postdoctoral fellowship by the Skye Foundation, which will enable her to continue her research. "And most importantly, translate this into services for HIV-infected women living in poor communities in South Africa," she said. Brandt worked with supervisor Dr Lauren Wild in the Department of Psychology and Emeritus Professor Andrew Dawes, currently of the Human Sciences Research Council.