***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES Despite the high prevalence of both mental illness and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome ( AIDS ) in developing countries , there are few data on the association between different forms of mental illness and sexual risk behaviours in re source -poor setting s. The objective of this study was to examine the association between mental illness and HIV risk behaviours in a South African township . STUDY DESIGN A cross-sectional study was performed among 645 individuals living in households selected at r and om . METHODS A self-administered translated question naire investigated sexual risk behaviours [ including sexual partners , condom use , casual sexual contacts , and sex in exchange for money , drugs or a place to stay ( transactional sex ) ] , depression ( measured using the Center for Epidemiological Studies Depression Scale ) , alcohol abuse ( from the Alcohol Use Disorders Identification Test ) , and post-traumatic stress disorder ( based on the Life Event Checklist ) . RESULTS Of the 645 individuals who completed the survey , 33 % reported depression , 17 % reported alcohol abuse , and 15 % reported post-traumatic stress disorder . After adjusting for demographic characteristics , the presence of any of these three conditions was strongly associated with experiences of forced sex [ adjusted odds ratio ( AOR ) 2.53 ; 95 % confidence intervals ( CI ) 1.60 - 4.02 ] , transactional sex ( AOR 2.88 ; 95 % CI 1.29 - 6.48 ) and increased condom use ( AOR 2.07 ; 95 % CI 1.32 - 3.25 ) . CONCLUSIONS These findings emphasize the substantial burden of mental illness in this setting , and its association with forced and transactional sex . The temporal nature of these associations is not always clear from this cross-sectional study , and additional prospect i ve research is required . Public health interventions are needed to address the dual burden of HIV/AIDS and mental illness in this and similar setting Background The 10-item Centre for Epidemiological Studies Depression Scale ( CES-D-10 ) is a depression screening tool that has been used in the South African National Income Dynamics Study ( NIDS ) , a national household panel study . This screening tool has not yet been vali date d in South Africa . This study aim ed to establish the reliability and validity of the CES-D-10 in Zulu , Xhosa and Afrikaans . The CES-D-10 ’s psychometric properties were also compared to the Patient Health Question naire ( PHQ-9 ) , a depression screening tool already vali date d in South Africa . Methods Stratified r and om sample s of Xhosa , Afrikaans and Zulu-speaking participants aged 15 years or older ( N = 944 ) were recruited from Cape Town Metro and Ethekwini districts .  Face-to-face interviews included socio-demographic questions , the CES-D-10 , Patient Health Question naire ( PHQ-9 ) , and WHO Disability Assessment Schedule 2.0 ( WHODAS ) . Major depression was determined using the Mini International Neuropsychiatric Interview . All instruments were translated and back-translated to English . Construct validity was examined using exploratory factor analysis with varimax rotation . Receiver Operating Characteristics ( ROC ) curves were used to investigate the CES-D-10 and PHQ-9 ’s criterion validity , and compared using the DeLong method . Results Overall , 6.6 , 18.0 and 6.9 % of the Zulu , Afrikaans and Xhosa sample s were diagnosed with depression , respectively . The CES-D-10 had acceptable internal consistency across sample s ( α = 0.69–0.89 ) , and adequate concurrent validity , when compared to the PHQ-9 and WHODAS . The CES-D-10 area under the Receiver Operator Characteristic curve was good to excellent : 0.81 ( 95 % CI 0.71–0.90 ) for Zulu , 0.93 ( 95 % CI 0.90–0.96 ) for Afrikaans , and 0.94 ( 95 % CI 0.89–0.99 ) for Xhosa . A cut-off of 12 , 11 and 13 for Zulu , Afrikaans and Xhosa , respectively , generated the most balanced sensitivity , specificity and positive predictive value ( Zulu : 71.4 , 72.6 % and 16.1 % ; Afrikaans : 84.6 % , 84.0 % , 53.7 % ; Xhosa : 81.0 % , 95.0 % , 54.8 % ) . These were slightly higher than those generated for the PHQ-9 . The CES-D-10 and PHQ-9 otherwise performed similarly across sample s. Conclusions The CES-D-10 is a valid , reliable screening tool for depression in Zulu , Xhosa and coloured Afrikaans population Background Self-report measures can guide clinical decisions and are useful when evaluating treatment outcomes . However , many clinicians do not use self-report measures systematic ally in their clinical practice . Internet-based question naires could facilitate administration , but the psychometric properties of the online version of an instrument should be explored before implementation . The recommendation from the International Test Commission is to test the psychometric properties of each question naire separately . Objective Our objective was to compare the psychometric properties of paper- and -pencil versions and Internet versions of two question naires measuring depressive symptoms . Methods The 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden . Participants completed the  Beck Depression Inventory ( BDI-II )  and the  Montgomery-Åsberg Depression Rating Scale — Self-rated ( MADRS-S )  , both on paper and on the Internet . The order was r and omized to control for order effects . Symptom severity in the sample ranged from mild to severe depressive symptoms . Results Psychometric properties of the two administration formats were mostly equivalent . The internal consistency was similar for the Internet and paper versions , and significant correlations were found between the formats for both MADRS-S ( r = .84 ) and the BDI-II ( r = .89 ) . Differences between paper and Internet total scores were not statistically significant for either question naire nor for the MADRS-S question dealing with suicidality ( item 9 ) when analyzed separately . The score on the BDI-II question about suicidality ( item 9 ) was significantly lower when administered via the Internet compared with the paper score , but the difference was small ( effect size , Cohen ’s [ d ] = 0.14 ) . There were significant main effects for order of administration on both question naires and significant interaction effects between format and order . This should not , however , pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made . Conclusions The MADRS-S can be transferred to online use without affecting the psychometric properties in a clinical ly meaningful way . The full BDI-II also seems to retain its properties when transferred ; however , the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study . The use of online question naires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save re sources 
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It was also evident that there were negligible differences in the psychometric properties of online versus paper versions of the online screening tools .