The effect of depressive symptoms and CD4 count on adherence to highly active antiretroviral therapy in sub-Saharan Africa
| Autor: | Patience Komba, Martine Etienne-Mesubi, Constance Shumba, Mercy Niyang, Sibhatu Biadgilign, Mian B. Hossain, Peter Memiah, Solomon Agbor |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Sub saharan Adolescent Immunology MEDLINE HIV Infections Dermatology lcsh:RC870-923 Affect (psychology) Medication Adherence Young Adult immune system diseases Antiretroviral Therapy Highly Active Medicine Humans Young adult Psychiatry Depression (differential diagnoses) Depressive symptoms Africa South of the Sahara Retrospective Studies Depressive Disorder Depression business.industry virus diseases Middle Aged lcsh:Diseases of the genitourinary system. Urology Antiretroviral therapy CD4 Lymphocyte Count Infectious Diseases Cross-Sectional Studies Anti-Retroviral Agents Female business |
| Zdroj: | Journal of the International Association of Providers of AIDS Care, Vol 13 (2014) |
| ISSN: | 2325-9574 |
| Popis: | Background: Studies have identified several programmatic and nonprogrammatic indicators that affect adherence to highly active antiretroviral therapy (HAART). Depression has been shown to impact adherence to HAART. This cross-sectional analysis of data collected from Nigeria, Uganda, Zambia, and Tanzania in 2008 examined the relationship between levels of depressive symptoms, clinical progression, and adherence to HAART. Methods: A multinational, multicenter, observational, retrospective cross-sectional evaluation of a population of focus comprised randomly selected patients on HAART. The dependent variable was adherence to HAART. The primary variable of interest to be assessed was patients’ level of depressive symptom score. A multivariable logistic regression model was used to examine the relationship between explanatory variables and adherence to HAART. Results: A total of 2344 patients were recruited for adherence survey. About 70% of the study sample reported having some level of depression. Logistic regression results show that patients who reported, respectively, low, moderate, and high levels of depressive symptoms are 35% ( P < .001), 56% ( P < .001), and 64% ( P < .001) less likely to adhere to HAART than those who reported having no depressive symptoms. At multivariate analysis, adherence to HAART was independently associated with the levels of depressive symptoms, older age, CD4 count >200 cells/mm3, Truvada (tenofovir [TDF]/emtricitabine [FTC])-based regimens, good knowledge about HAART, and longer period on therapy. Conclusions: These results indicate that mental health and clinical parameters are significant factors in determining patients’ adherence to their HAART, which need to be more aggressively addressed as a critical component of care and treatment support. |
| Databáze: | OpenAIRE |
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