Scielo RSS <![CDATA[SAMJ: South African Medical Journal]]> http://www.scielo.org.za/rss.php?pid=0256-957420090005&lang=en vol. 99 num. 5 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Vaccines for Africa (VACFA) website</b>: <b>an innovative immunisation advocacy tool</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500001&lng=en&nrm=iso&tlng=en <![CDATA[<b>The 2003 - 2005 measles outbreak</b>: <b>complacency, HIV infection and neglect of vitamin A treatment</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500002&lng=en&nrm=iso&tlng=en <![CDATA[<b>We can train them, but how can we retain them?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500003&lng=en&nrm=iso&tlng=en <![CDATA[<b>The tokoloshe homunculus</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500004&lng=en&nrm=iso&tlng=en <![CDATA[<b>HRT prescriptions linked to 25% of breast cancers in California</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500005&lng=en&nrm=iso&tlng=en <![CDATA[<b>Medical aid double standards</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500006&lng=en&nrm=iso&tlng=en <![CDATA[<b>Free State ARV crisis</b>: <b>central government blamed</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500007&lng=en&nrm=iso&tlng=en <![CDATA[<b>No pay, no cure</b>: <b>can our hospitals be salvaged?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500008&lng=en&nrm=iso&tlng=en <![CDATA[<b>Qualified ethics nod to doctors downing tools</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500009&lng=en&nrm=iso&tlng=en <![CDATA[<b>Bio-ethics vigilance vital</b>: <b>medical and legal doyens</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500010&lng=en&nrm=iso&tlng=en <![CDATA[<b>Hydatid disease masquerading as an incisional hernia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500011&lng=en&nrm=iso&tlng=en <![CDATA[<b>Mao Tse-tung (1893 - 1976)</b>: <b>his habits and his health</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500012&lng=en&nrm=iso&tlng=en <![CDATA[<b>David Bourne</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500013&lng=en&nrm=iso&tlng=en <![CDATA[<b>Paediatric liver transplantation in South Africa in 2009</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500014&lng=en&nrm=iso&tlng=en <![CDATA[<b>Management of cryptoccocal meningitis in resource-limited settings</b>: <b>a systematic review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500015&lng=en&nrm=iso&tlng=en <![CDATA[<b>Chronic bilateral anterior shoulder dislocation</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500016&lng=en&nrm=iso&tlng=en <![CDATA[<b>Measles outbreak in South Africa, 2003 - 2005</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500017&lng=en&nrm=iso&tlng=en OBJECTIVES: Measles was virtually eliminated in South Africa following control activities in 1996/7. However, from July 2003 to November 2005, 1 676 laboratory-confirmed measles cases were reported in South Africa. We investigated the outbreak's cause and the role of HIV. DESIGN: We traced laboratory-confirmed case-patients residing in the Johannesburg metropolitan (JBM) and O R Tambo districts. We interviewed laboratory- or epidemiologically confirmed case-patients or their caregivers to determine vaccination status and, in JBM, HIV status. We calculated vaccine effectiveness using the screening method. SETTING: Household survey in JBM and O R Tambo districts. OUTCOME MEASURES: Vaccine effectiveness, case-fatality rate, and hospitalisations. RESULTS: In JBM, 109 case-patients were investigated. Of the 57 case-patients eligible for immunisation, 27 (47.4%) were vaccinated. Fourteen (12.8%) case-patients were HIV infected, 46 (42.2%) were HIV uninfected, and 49 (45.0%) had unknown HIV status. Among children aged 12 - 59 months, vaccine effectiveness was 85% (95% confidence interval (CI): 63, 94) for all children, 63% for HIV infected, 75% for HIV uninfected, and 96% for children with unknown HIV status. (Confidence intervals were not calculated for sub-groups owing to small sample size.) In O R Tambo district, 157 case-patients were investigated. Among the 138 case-patients eligible for immunisation, 41 (29.7%) were vaccinated. Vaccine effectiveness was 89% (95% CI 77, 95). CONCLUSIONS: The outbreak's primary cause was failure to vaccinate enough of the population to prevent endemic measles transmission. Although vaccine effectiveness might have been lower in HIV-infected than in uninfected children, population vaccine effectiveness remained high. <![CDATA[<b>Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital)</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500018&lng=en&nrm=iso&tlng=en BACKGROUND: Antiretroviral therapy (ART) is being extended across South Africa. While efforts have been made to assess the costs of providing ART via accredited service points, little information is available on its downstream costs, particularly in public secondary level hospitals. OBJECTIVES: To determine the cost of care for inpatients and outpatients at a dedicated antiretroviral referral unit treating and caring for antiretroviral-related conditions in a South African peri-urban setting; to identify key epidemiological cost drivers; and to examine the associated clinical and outcome data. METHODS: A prospective costing study on 48 outpatients and 25 inpatients was conducted from a health system perspective. Incremental economic costs and clinical data were collected from primary sources at G F Jooste Hospital, Cape Town, over a 1-month period (March 2005). RESULTS: Incremental cost per outpatient was R1 280, and per inpatient R5 802. Costs were dominated by medical staff costs (62% inpatient and 58% outpatient, respectively). Infections predominated among diagnoses and costs - 55% and 67% respectively for inpatients, and 49% and 54% respectively for outpatients. Most inpatients and outpatients were judged by attending physicians to have improved or stabilised as a result of treatment (52% and 59% respectively). CONCLUSIONS: The costs of providing secondary level care for patients on or immediately preceding ART initiation can be significant and should be included in the government's strategic planning: (i) so that the service can be expanded to meet current and future needs; and (ii) to avoid crowding out other secondary level health services. <![CDATA[<b>Associations between body mass index and serum levels of C-reactive protein</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500019&lng=en&nrm=iso&tlng=en BACKGROUND: Obesity leads to increased risk of cardiovascular disease and glucose intolerance, which are phenomena of chronic inflammation. This study was performed to determine whether a higher body mass index (BMI) and central obesity are associated with low-grade inflammation. METHODS: An analysis of 8 453 adults aged >20 years was performed. Every subject completed a household interview and a questionnaire regarding personal health, and their BMI and serum C-reactive protein (CRP) level were measured. The BMI data were divided into quintiles, using multiple linear regression to estimate the relationship between CRP level and BMI quintiles. An extended-model approach was used for covariate adjustment. The association between central obesity and CRP level was examined by this method as well. RESULTS: After controlling for demographics, chronic diseases, health behaviours and levels of folate and vitamin B12, the β coefficient (which represents the change of natural-log-transformed levels of CRP for each kg/m2 increase in BMI) was 0.078 (p<0.001). The CRP levels also increased across increasing quintiles of BMI (p for trend <0.001). The β coefficient, representing the change of natural-log-transformed levels of CRP comparing subjects with central obesity to those without, was 0.876 (p<0.001). CONCLUSION: Higher BMIs as well as central obesity are independently associated with higher levels of CRP. <![CDATA[<b>Metabolic syndrome and obesity among workers at Kanye Seventh-day Adventist Hospital, Botswana</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500020&lng=en&nrm=iso&tlng=en INTRODUCTION: Metabolic syndrome and obesity are risk factors for developing type 2 diabetes mellitus and/or cardiovascular disease, especially stroke. There is evidence worldwide of the high prevalence of these pathologies in health care providers. OBJECTIVES: To determine the frequency of metabolic syndrome, overweight, obesity and risk of developing metabolic syndrome in workers at Kanye Seventh-day Adventist Hospital, Kanye, Botswana. METHODS: An observational and cross-sectional study. For the detection of metabolic syndrome, the criteria of the Adult Treatment Panel III were used; for obesity, the body mass index of 150 workers was applied. Data were grouped and analysed according to gender, age and type of work. RESULTS: Thirty-four per cent of the hospital's workers had metabolic syndrome, the same percentage were at high risk of developing metabolic syndrome, 28.7% were obese, and 27.3% were overweight. Female gender was found to be strongly associated with obesity and metabolic syndrome. The age group of 35 - 54 years was most affected. CONCLUSIONS: There is a high prevalence of obesity and metabolic syndrome among Kanye Seventh-day Adventist Hospital workers. We recommend the implementation of programmes to screen these risk factors by means of routine medical exams and improving the lifestyles of Botswana health care workers. The study findings could be the basis for future research among hospital staff and the general population. <![CDATA[<b>The South African Stress and Health (SASH) study</b>: <b>a scientific base for mental health policy</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500021&lng=en&nrm=iso&tlng=en INTRODUCTION: Metabolic syndrome and obesity are risk factors for developing type 2 diabetes mellitus and/or cardiovascular disease, especially stroke. There is evidence worldwide of the high prevalence of these pathologies in health care providers. OBJECTIVES: To determine the frequency of metabolic syndrome, overweight, obesity and risk of developing metabolic syndrome in workers at Kanye Seventh-day Adventist Hospital, Kanye, Botswana. METHODS: An observational and cross-sectional study. For the detection of metabolic syndrome, the criteria of the Adult Treatment Panel III were used; for obesity, the body mass index of 150 workers was applied. Data were grouped and analysed according to gender, age and type of work. RESULTS: Thirty-four per cent of the hospital's workers had metabolic syndrome, the same percentage were at high risk of developing metabolic syndrome, 28.7% were obese, and 27.3% were overweight. Female gender was found to be strongly associated with obesity and metabolic syndrome. The age group of 35 - 54 years was most affected. CONCLUSIONS: There is a high prevalence of obesity and metabolic syndrome among Kanye Seventh-day Adventist Hospital workers. We recommend the implementation of programmes to screen these risk factors by means of routine medical exams and improving the lifestyles of Botswana health care workers. The study findings could be the basis for future research among hospital staff and the general population. <![CDATA[<b>The South African Stress and Health (SASH) study</b>: <b>12-month and lifetime prevalence of common mental disorders</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500022&lng=en&nrm=iso&tlng=en BACKGROUND: The South African Stress and Health (SASH) study is the first large-scale population-based study of common mental disorders in the country. This paper provides data on the 12-month and lifetime prevalence of these conditions. METHODS: Data from a nationally representative sample of 4 351 adults were analysed. Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). An extensive survey questionnaire detailed contextual and socio-demographic factors, onset and course of mental disorders, and risk factors. Simple weighted cross-tabulation methods were used to estimate prevalence, and logistic regression analysis was used to study correlates of 12-month and lifetime prevalence. RESULTS: The lifetime prevalence for any disorder was 30.3%, and the most prevalent 12-month and lifetime disorders were the anxiety disorders. The Western Cape had the highest 12-month and lifetime prevalence rates, and the lowest rates were in the Northern Cape. CONCLUSIONS: The SASH study shows relatively high 12-month and lifetime prevalence rates. These findings have significant implications for planning mental health services. <![CDATA[<b>Mental health service use among South Africans for mood, anxiety and substance use disorders</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500023&lng=en&nrm=iso&tlng=en BACKGROUND: Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. DESIGN: A nationally representative survey of 4 351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) diagnoses, severity, and service utilisation were determined using the World Health Organization Composite International Diagnostic Interview (CIDI). Twelve-month treatment was categorised by sector and province. South Africans in households and hostel quarters were interviewed between 2002 and 2004 in all nine provinces. OUTCOME MEASURES: 4 317 respondents 18 years and older were analysed. Bivariate logistic regression models predicted (i) 12-month treatment use of service sectors by gender, and (ii) 12-month treatment use by race by gender. RESULTS: Of respondents with a mental disorder, 25.2% had sought treatment within the previous 12 months; 5.7% had used any formal mental health service. Mental health service use was highest for adults with mood and anxiety disorders, and among those with a mental disorder it varied by province, from 11.4% (Western Cape) to 2.2% (Mpumalanga). More women received treatment, and this was largely attributable to higher rates of treatment in women with mood disorders. Age, income, education and marital status were not significantly associated with mental health service use. Race was associated with the treatment sector accessed in those with a mental disorder. CONCLUSIONS: There is a substantial burden of untreated mental disorders in the South African population, across all provinces and even in those with substantial impairment. Greater allocation of resources to mental health services and more community awareness initiatives are needed to address the unmet need. <![CDATA[<b>Impact of common mental disorders during childhood and adolescence on secondary school completion</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500024&lng=en&nrm=iso&tlng=en There are few data from South Africa and other low- and middle-income countries on how mental disorders in childhood and adolescence may influence different aspects of socio-economic position, including educational attainment. We examined the association between early-onset disorders and subsequent educational achievement in a nationally representative sample of 4 351 South African adults. After adjusting for participant demographic characteristics and traumatic life events, post-traumatic stress disorder, major depressive disorder and substance-related disorders were each associated with increased odds of failing to complete secondary education (odds ratios and 95% confidence intervals 2.3, 1.0 - 5.1; 1.7, 1.2 - 2.5, and 1.7, 1.2 - 2.5, respectively). These data point to the role that early-life mental disorders may play in educational achievement and subsequent socio-economic position over the life course. <![CDATA[<b>Patterns of substance use in South Africa</b>: <b>results from the South African Stress and Health study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500025&lng=en&nrm=iso&tlng=en BACKGROUND: There are limited data on substance use in South Africa. We describe patterns of substance use based on recent, nationally representative data. METHODS: Data were derived from the 2002 - 2004 South African Stress and Health (SASH) study. A nationally representative household probability sample of 4 351 adults was interviewed using the paper and pencil version of the World Health Organization Composite International Diagnostic Interview (CIDI). Data are reported for lifetime use, socio-demographic correlates of use, and age of cohort predicting lifetime use for four classes of drugs. RESULTS: The estimate for cumulative occurrence of alcohol use was 38.7%, of tobacco smoking 30.0%, of cannabis use 8.4%, of other drug use 2.0%, and of extra-medical psychoactive drug use 19.3%. There were statistically significant associations between male gender and alcohol, tobacco, cannabis and other drug use. Coloureds and whites were more likely than blacks to have used alcohol, tobacco and other drugs. Clear cohort variations existed in the age of initiation of drug use; these were most marked for other drugs and for extra-medical drug use. Use of all drug types was much more common in recent cohorts, with a similar cumulative incidence of tobacco, alcohol and cannabis use across age cohorts. CONCLUSIONS: Epidemiological patterns of use for alcohol, tobacco, cannabis, other drugs and extra-medical drugs provide the first nationally representative data. New findings on race and exploratory data on time trends provide a foundation for future epidemiological work on drug use patterns across birth cohorts and population subgroups in South Africa. <![CDATA[<b>The epidemiology of major depression in South Africa</b>: <b>results from the South African Stress and Health study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500026&lng=en&nrm=iso&tlng=en BACKGROUND: Mental disorders are a major contributor to the burden of disease in all regions of the world. There are limited data on the epidemiology of major depressive disorder in South Africa. METHODS: A nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to establish a diagnosis of depression. The dataset analysed included 4 351 adult South Africans of all racial groups. RESULTS: The prevalence of major depression was 9.7% for lifetime and 4.9% for the 12 months prior to the interview. The prevalence of depression was significantly higher among females than among males. The prevalence was also higher among those with a low level of education. Over 90% of all respondents with depression reported global role impairment. CONCLUSION: In comparison with data from other countries, South Africa has lower rates of depression than the USA but higher rates than Nigeria. The findings are broadly consistent with previous findings in South Africa. These findings are the first step in documenting a level of need for care in a context of significant under-funding of mental health services and research in South Africa. <![CDATA[<b>Life stress and mental disorders in the South African Stress and Health study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500027&lng=en&nrm=iso&tlng=en BACKGROUND: Although stressful life events (SLEs) are associated with psychopathology, the contribution from distal and proximal events and the specificity of their association with common mental disorders require further exploration. We examined the association of recent life events and past adversities to mood, anxiety, substance use and impulse control disorders in South Africa. METHODS: Data were analysed from the South African Stress and Health study, a population-based study of mental disorders in a nationally representative sample of 4 351 adults. Psychiatric disorders were assessed with the Composite International Diagnostic Interview (CIDI). This included questions covering early and later SLEs (negative life events, relationship stress, partner violence, social strain and adverse events during childhood) and various socio-demographic variables. Logistic regression models were constructed for 3 957 respondents (2 371 female, 1 586 male) with no missing covariate data, to assess life stress and socio-demographic predictors of 12-month and lifetime disorder. RESULTS: Recent negative life events and relationship problems were significant predictors of any 12-month disorder and any lifetime disorder. Physical partner violence predicted any lifetime disorder. There was evidence of specificity for the prediction of mood versus anxiety disorders, with childhood adversity specifically associated with mood disorders but not anxiety disorders. Single marital status was the strongest socio-demographic predictor of any 12-month and any lifetime disorder. CONCLUSIONS: Stressful life events, distal and proximal, contribute significantly and independently to the prediction of major psychiatric disorders among South Africans, underscoring the importance of screening adversities in adults with common mental disorders, and of providing appropriate adjunctive interventions. <![CDATA[<b>Perceived discrimination and mental health disorders</b>: <b>the South African Stress and Health study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500028&lng=en&nrm=iso&tlng=en OBJECTIVES: To describe the demographic correlates of perceived discrimination and explore the association between perceived discrimination and psychiatric disorders. DESIGN: A national household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses of psychiatric disorders. Additional instruments provided data on perceived discrimination and related variables. SETTING: A nationally representative sample of adults in South Africa. SUBJECTS: 4 351 individuals aged 18 years and older. OUTCOMES: 12-month and lifetime mood, anxiety and substance use disorders.] RESULTS: In the multivariate analyses, acute and chronic racial discrimination were associated with an elevated risk of any 12-month DSM-IV disorder when adjusted for socio-demographic factors, but this association was no longer statistically significant when adjusted for other sources of social stress. In fully adjusted models, acute racial discrimination was associated with an elevated risk of lifetime substance use disorders. Acute and chronic non-racial discrimination were associated with an elevated risk of 12-month and lifetime rates of any disorder, even after adjustment for other stressors and potentially confounding psychological factors. The association of chronic non-racial discrimination and 12-month and lifetime disorder was evident across mood, anxiety, and substance use disorders in the fully adjusted models. CONCLUSION: The risk of psychiatric disorders is elevated among persons who report experiences of discrimination. These associations are more robust for chronic than for acute discrimination and for non-racial than for racial discrimination. Perceived discrimination constitutes an important stressor that should be taken into account in the aetiology of psychiatric disorders. <![CDATA[<b>Perpetration of gross human rights violations in South Africa</b>: <b>association with psychiatric disorders</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500029&lng=en&nrm=iso&tlng=en BACKGROUND: A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial. METHODS: Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed. RESULTS: HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence ( DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders. CONCLUSION: Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention. <![CDATA[<b>DSM-IV-defined common mental disorders</b>: <b>association with HIV testing, HIV-related fears, perceived risk and preventive behaviours among South African adults</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000500030&lng=en&nrm=iso&tlng=en BACKGROUND: There are few reports from South Africa on how common mental disorders may be associated with HIV-related perceptions and behaviours. METHODS: Between 2002 and 2004, 4 351 South African adults were interviewed. Psychiatric diagnoses of depression, anxiety and substance abuse disorders were based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). HIV-related fears, perceived risk and behaviour change were measured using multi-item scales. We analysed forms of behaviour change that were appropriate for risk reduction (such as changes in sexual behaviour) separately from behaviour changes that were inappropriate to prevent HIV (such as care over things touched or avoiding certain social situations). RESULTS: The presence of any DSM-IV-defined disorder during the previous 12 months was associated with previous HIV testing, increased HIV-related fears, and high levels of perceived risk of HIV. There were no associations between depression, anxiety and substance abuse disorders and appropriate forms of behaviour change for HIV risk reduction. However, individuals with an anxiety or a depressive disorder were more likely to report inappropriate forms of behaviour change. For example, individuals with any depressive and/or anxiety disorders were 1.57 and 1.47 times more likely, respectively, to report avoiding certain social situations to prevent HIV/AIDS compared with those who did not have such disorders (p<0.01 for both associations). DISCUSSION: The lack of appropriate forms of behaviour change to prevent HIV transmission, despite increased levels of HIV-related fear and perceived risk, underscores the need for HIV risk reduction interventions for individuals living with common mental disorders in South Africa.