Examining the relationship between psychological distress and adherence to anti-retroviral therapy among Ugandan adolescents living with HIV

被引:54
|
作者
Mutumba, Massy [1 ,2 ]
Musiime, Victor [2 ,3 ]
Lepkwoski, James M. [4 ]
Harper, Gary W. [1 ]
Snow, Rachel C. [1 ]
Resnicow, Ken [1 ]
Bauermeister, Jose A. [1 ]
机构
[1] Univ Michigan, Hlth Behav & Biol Sci, Ann Arbor, MI 48109 USA
[2] Joint Clin Res Ctr, Kampala, Uganda
[3] Makerere Univ, Dept Pediat, Coll Hlth Sci, Kampala, Uganda
[4] Univ Michigan, Survey Methodol Program, Ann Arbor, MI 48109 USA
关键词
Youth; HIV care; mental health; Africa; coping; SOCIAL SUPPORT; MEDICATION ADHERENCE; DRUG-RESISTANCE; MENTAL-HEALTH; PREDICTORS; CHILDREN; DEPRESSION; REGIMENS; OUTCOMES; RELIGION;
D O I
10.1080/09540121.2015.1131966
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Psychological distress is common among adolescents living with HIV (ALHIV) worldwide, and has been associated with non-adherence to anti-retroviral therapy (ART), leading to poor virologic suppression, drug resistance, and increased risk for AIDS morbidity and mortality. However, only a few studies have explored the relationship between psychological distress and ART adherence among adolescents in sub-Saharan Africa. The paper examines the relationship between psychological distress and ART adherence, and effect of psychosocial resources on ART adherence. We conducted a cross-sectional survey of 464 ALHIV (aged 12-19; 53% female) seeking HIV care at a large HIV treatment center in Kampala, Uganda. ALHIV were recruited during routine clinic visits. Three self-reported binary adherence measures were utilized: missed pills in the past three days, non-adherence to the prescribed medical regimen, and self-rated adherence assessed using a visual analog scale. Psychological distress was measured as a continuous variable, and computed as the mean score on a locally developed and validated 25-item symptom checklist for Ugandan ALHIV. Psychosocial resources included spirituality, religiosity, optimism, social support, and coping strategies. After adjusting for respondents' socio-demographic characteristics and psychosocial resources, a unit increase in psychological distress was associated with increased odds of missing pills in past 3 days (Odds Ratio(OR)=1.75; Confidence Interval (CI): 1.04-2.95), not following the prescribed regimen (OR=1.63; CI: 1.08-2.46), and lower self-rated adherence (OR=1.79; CI: 1.19-2.69). Psychosocial resources were associated with lower odds for non-adherence on all three self-report measures. There is a need to strengthen the psychosocial aspects of adolescent HIV care by developing interventions to identify and prevent psychological distress among Ugandan ALHIV.
引用
收藏
页码:807 / 815
页数:9
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