Exploring the Link between Mental Health and Treatment Adherence in People Living with HIV: A Structured Questionnaire-Based Study.
People living with human immunodeficiency virus (PLHIV) commonly experience psychological issues, including anxiety disorders and depression, which may affect their adherence to antiretroviral therapy. This study aimed to explore the mental health status of PLHIV and identify the factors associated with poor compliance (PC) with antiretroviral therapy.
A structured questionnaire survey was administered to PLHIV who were regularly followed up at a university hospital from September 19 to 20, 2020. The survey encompassed assessments of depression (by using the Patient Health Questionnaire-9), anxiety (by using the Beck Anxiety Inventory-Primary Care), suicidality, and meaning in life (by using the Meaning in Life Questionnaire). For participants who provided consent for identification, demographic information was merged to facilitate the analysis. PC was determined based on whether individuals made themselves available for routine clinical visits.
Among 327 eligible PLHIV, 150 individuals (45.9%) completed the survey. Forty-one out of the 150 individuals (27.3%) screened positive for depression, while 52 (34.7%) screened positive for anxiety disorders. Thirty-two participants (21.3%) presented with symptoms indicative of both depression and anxiety. The most prevalent depressive symptom was trouble sleeping, accounting for 29.3% of respondents, followed by fatigue (26.0%). Over nervousness was the most commonly reported anxiety symptom (22.7%). Furthermore, 32 individuals (21.3%) reported experiencing suicidal ideation or engaging in self-injury. Among the 123 participants who agreed to identify themselves, suicide attempts and low CD4 counts were positively correlated with PC (adjusted odds ratio [aOR], 3.34; 95% confidence interval [CI], 1.29-8.91 and OR, 5.46; 95% CI, 1.27-24.78, respectively), and younger age was found to be associated with PC (aOR, 0.93; 95% CI, 0.88-0.97; P=0.004). When measures of anxiety disorder and depression were incorporated into the analysis, depression exhibited an OR of 14 for PC (aOR, 13.98; 95% CI, 3.29-98.65; P=0.001). Anxiety disorders were found to be inversely associated with PC. History of opportunistic infection and Meaning in Life Questionnaire scores were not significantly associated with PC.
The prevalence of depression and anxiety disorders was high in PLHIV. Depression and low CD4 counts under regular follow-up were associated with PC. Thus, screening for depression can be effective in reducing non-adherence to antiretroviral therapy.
A structured questionnaire survey was administered to PLHIV who were regularly followed up at a university hospital from September 19 to 20, 2020. The survey encompassed assessments of depression (by using the Patient Health Questionnaire-9), anxiety (by using the Beck Anxiety Inventory-Primary Care), suicidality, and meaning in life (by using the Meaning in Life Questionnaire). For participants who provided consent for identification, demographic information was merged to facilitate the analysis. PC was determined based on whether individuals made themselves available for routine clinical visits.
Among 327 eligible PLHIV, 150 individuals (45.9%) completed the survey. Forty-one out of the 150 individuals (27.3%) screened positive for depression, while 52 (34.7%) screened positive for anxiety disorders. Thirty-two participants (21.3%) presented with symptoms indicative of both depression and anxiety. The most prevalent depressive symptom was trouble sleeping, accounting for 29.3% of respondents, followed by fatigue (26.0%). Over nervousness was the most commonly reported anxiety symptom (22.7%). Furthermore, 32 individuals (21.3%) reported experiencing suicidal ideation or engaging in self-injury. Among the 123 participants who agreed to identify themselves, suicide attempts and low CD4 counts were positively correlated with PC (adjusted odds ratio [aOR], 3.34; 95% confidence interval [CI], 1.29-8.91 and OR, 5.46; 95% CI, 1.27-24.78, respectively), and younger age was found to be associated with PC (aOR, 0.93; 95% CI, 0.88-0.97; P=0.004). When measures of anxiety disorder and depression were incorporated into the analysis, depression exhibited an OR of 14 for PC (aOR, 13.98; 95% CI, 3.29-98.65; P=0.001). Anxiety disorders were found to be inversely associated with PC. History of opportunistic infection and Meaning in Life Questionnaire scores were not significantly associated with PC.
The prevalence of depression and anxiety disorders was high in PLHIV. Depression and low CD4 counts under regular follow-up were associated with PC. Thus, screening for depression can be effective in reducing non-adherence to antiretroviral therapy.
Authors
Baek Baek, Yoon Yoon, Lee Lee, Kim Kim, Hong Hong, Kang Kang, Jung Jung, Kim Kim
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