Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia

 

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dc.contributor.author Asrat, Biksegn
dc.contributor.author Lund, Crick
dc.contributor.author Ambaw, Fentie
dc.contributor.author Garman, Emily C
dc.contributor.author Schneider, Marguerite
dc.date.accessioned 2021-06-23T13:26:31Z
dc.date.available 2021-06-23T13:26:31Z
dc.date.issued 2020-09-24
dc.identifier.citation Asrat, B., Lund, C., Ambaw, F., Garman, E.C. & Schneider, M. 2020. Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia. <i>BMC Psychiatry.</i> 20(1):462. http://hdl.handle.net/11427/33388 en_ZA
dc.identifier.uri https://doi.org/10.1186/s12888-020-02865-w
dc.identifier.uri http://hdl.handle.net/11427/33388
dc.description.abstract Abstract Background Major depression is believed to affect treatment adherence and overall quality of life (QoL) of people living with HIV/AIDS (PLWHA). Comorbid major depression contributes to a two-fold higher risk of mortality among PLWHA. Understanding the relationships of major depression, adherence to antiretroviral therapy (ART) and QoL is important to identify areas for intervention. The aim of this study is to examine relationship of major depressive disorder (MDD) and adherence to ART with QoL, and to investigate socio-demographic and clinical factors associated with MDD, adherence and QoL among PLWHA in Northwest Ethiopia. Method A cross-sectional study was conducted in the ART clinic of Felege-Hiwot referral hospital in Northwest Ethiopia from July to October 2019. Adult PLWHA were selected using a systematic random sampling technique. Data were collected using interview administered questionnaires and chart reviews. Mini International Neuropsychiatric Interview and WHOQOL-HIV-BREF-Eth instruments were used to measure MDD and QoL respectively. Adherence to ART was assessed using pill count data from patients’ adherence monitoring chart. Univariate and multivariate Poisson regressions were used to assess associations of socio-demographic and clinical factors with MDD and adherence to ART. A multivariate linear regression was used to examine the associations of both MDD and adherence with overall QoL. Result Of the total of 393 invited participants, 391 (99.5%) completed the interviews. MDD was negatively associated with overall QoL: participants with MDD had a lower QoL score of 0.17 points compared to those with no MDD. MDD was associated with reduced adherence to ART when functional disability was controlled (RR = 1.43; 95%CI = 1.05, 1.96; p = 0.025). However, there was no statistical association between adherence to ART and overall QoL. Functional disability was associated with both MDD (RR = 5.07; 95%CI = 3.27,7.86; p < 0.001) and overall QoL (β = 0.29; 95%CI = 0.21,0.36; p < 0.001). Conclusion The relationship between MDD and QoL indicates the need for feasible, acceptable and evidence-based mental health interventions to reduce depression and improve overall QoL of PLWHA. We recommend future studies investigate causal relationships of MDD, adherence to ART and QoL of PLWHA to better understand priority areas for intervention.
dc.source BMC Psychiatry
dc.source.uri https://bmcpsychiatry.biomedcentral.com/
dc.subject Major depressive disorder
dc.subject HIV
dc.subject Adherence to ART
dc.subject Quality of life
dc.subject Ethiopia
dc.title Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia
dc.type Journal Article
dc.date.updated 2020-09-27T03:22:01Z
dc.language.rfc3066 en
dc.rights.holder The Author(s)
dc.source.journalvolume 20
dc.source.journalissue 1
dc.source.pagination 462
dc.identifier.apacitation Asrat, B., Lund, C., Ambaw, F., Garman, E. C., & Schneider, M. (2020). Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia. <i>BMC Psychiatry</i>, 20(1), 462. http://hdl.handle.net/11427/33388 en_ZA
dc.identifier.chicagocitation Asrat, Biksegn, Crick Lund, Fentie Ambaw, Emily C Garman, and Marguerite Schneider "Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia." <i>BMC Psychiatry</i> 20, 1. (2020): 462. http://hdl.handle.net/11427/33388 en_ZA
dc.identifier.vancouvercitation Asrat B, Lund C, Ambaw F, Garman EC, Schneider M. Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia. BMC Psychiatry. 2020;20(1):462. http://hdl.handle.net/11427/33388. en_ZA
dc.identifier.ris TY - Journal Article AU - Asrat, Biksegn AU - Lund, Crick AU - Ambaw, Fentie AU - Garman, Emily C AU - Schneider, Marguerite AB - Abstract Background Major depression is believed to affect treatment adherence and overall quality of life (QoL) of people living with HIV/AIDS (PLWHA). Comorbid major depression contributes to a two-fold higher risk of mortality among PLWHA. Understanding the relationships of major depression, adherence to antiretroviral therapy (ART) and QoL is important to identify areas for intervention. The aim of this study is to examine relationship of major depressive disorder (MDD) and adherence to ART with QoL, and to investigate socio-demographic and clinical factors associated with MDD, adherence and QoL among PLWHA in Northwest Ethiopia. Method A cross-sectional study was conducted in the ART clinic of Felege-Hiwot referral hospital in Northwest Ethiopia from July to October 2019. Adult PLWHA were selected using a systematic random sampling technique. Data were collected using interview administered questionnaires and chart reviews. Mini International Neuropsychiatric Interview and WHOQOL-HIV-BREF-Eth instruments were used to measure MDD and QoL respectively. Adherence to ART was assessed using pill count data from patients’ adherence monitoring chart. Univariate and multivariate Poisson regressions were used to assess associations of socio-demographic and clinical factors with MDD and adherence to ART. A multivariate linear regression was used to examine the associations of both MDD and adherence with overall QoL. Result Of the total of 393 invited participants, 391 (99.5%) completed the interviews. MDD was negatively associated with overall QoL: participants with MDD had a lower QoL score of 0.17 points compared to those with no MDD. MDD was associated with reduced adherence to ART when functional disability was controlled (RR = 1.43; 95%CI = 1.05, 1.96; p = 0.025). However, there was no statistical association between adherence to ART and overall QoL. Functional disability was associated with both MDD (RR = 5.07; 95%CI = 3.27,7.86; p < 0.001) and overall QoL (β = 0.29; 95%CI = 0.21,0.36; p < 0.001). Conclusion The relationship between MDD and QoL indicates the need for feasible, acceptable and evidence-based mental health interventions to reduce depression and improve overall QoL of PLWHA. We recommend future studies investigate causal relationships of MDD, adherence to ART and QoL of PLWHA to better understand priority areas for intervention. DA - 2020-09-24 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Psychiatry KW - Major depressive disorder KW - HIV KW - Adherence to ART KW - Quality of life KW - Ethiopia LK - https://open.uct.ac.za PY - 2020 T1 - Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia TI - Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia UR - http://hdl.handle.net/11427/33388 ER - en_ZA


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