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

Bibliographic Data

ID19440248
AuthorsMassy Mutumba (0000-0002-0636-891X, University of Michigan, corresponding author), Victor Musiime (0000-0001-7472-9054, Joint Clinical Research Centre), James M Lepkwoski (University of Michigan), G W Harper (0000-0003-1011-1751, University of Michigan), Rachel C Snow, Rachel Snow (University of Michigan), K Resnicow (0000-0003-1416-9627, University of Michigan), Jose A Bauermeister, Jose Bauermeister (0000-0002-9276-2306, University of Michigan)
Year2016
Volume28
Issue7
Pages807-815
Publication date2016-07-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2015.1131966
PMID27294696
OpenAlexW2233860601
LanguageEN
Citations received18
References cited55

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

Distress · Odds ratio · Pill · Psychiatry · Psychosocial · Psychotherapist · Regimen · Religiosity · Social support · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV/AIDS Research and Interventions · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Nursing · Psychology · Internal Medicine