Abstract:
OBJECTIVE: Research on HIV in South Africa has not reflected the impact of the disease on psychiatric patients. The aims of the
study were: to compare the HIV prevalence among patient groups in Weskoppies Hospital; to compare psychiatric diagnoses of
infected and non-infected patients; to assess intravenous drug use and high-risk sexual behaviour; to establish HIV-syphilis
association; and to investigate the rapid test performance for screening, compared to the confirmatory ELISA test. METHOD: Onehundred-
and-ninety-five patients were grouped into four categories according to their duration of admission and gender. HIV
rapid testing, HIV ELISA, syphilis-RPR and TPHA testing were performed. RESULTS: The HIV prevalence of 11% in the sample was
significantly associated with ‘gender-and-duration-of-admission’ categories (p=0.003). No significant association between HIV
infection and psychiatric diagnoses or intravenous drug use was found, but a significant association existed between HIV infection
and high-risk sexual behaviour (p=0.002), and between HIV and syphilis (p=0.012). The HIV rapid screening test had a sensitivity
of 91.7% and a specificity of 98.2%. CONCLUSION: The overall HIV prevalence at Weskoppies Hospital remains lower than the
national average, but has increased since a previous local study. The rapid test for HIV had a lower sensitivity than was expected,
and it is recommended that HIV ELISA testing be performed as a first line test in the setting of hospitalised patients. Due to the
high prevalence of HIV and syphilis in the psychiatric population it is recommended that all patients be tested for both of these
diseases.
