Predictors of Poor Quality of Life among People Living with HIV/AIDS on Antiretroviral therapy in Jimma zone Public Hospitals, South West Ethiopia: A Mixed-method Study.

Abstract

Background: Given the benefits of ART (Antiretroviral Therapy) for people living with HIV/AIDS, their quality of life continues to impair. Moreover, several studies have been investigated the magnitude of quality of life among developed countries with a paucity of behavioral and psychosocial factors. Thus, the objective of this study was to identify predictors of poor quality of life among people living with HIV on ART in Jimma Zone Public Hospitals, Southwest Ethiopia. Methods: Institution-based case-control study triangulated with a qualitative method was employed. The sample size was determined using Epi-info 7.1.1 using the ratio of 1:3 cases to controls. A simple random sampling technique was conducted to select cases and controls. Data were entered into Epi-Data and analyzed using SPSS version 20. Qualitative data were collected from purposely selected key informants and analyzed manually. The study was conducted from March 10 to April 30, 2018.Results: a total of 81(25.1%) cases and 242(75.9%) controls were included in the study. Those PLWHA who chew Khat occasionally (AOR: 4.3; 95% CI: 1.01,17.8) and at weakly intervals (AOR: 6.3, 95% CI:2.0, 20.7), Stigmatism(AOR: 9.2; 95% CI:3.5, 24.3), severe depression(AOR: 16.1; 95% CI:5.2, 49.6), fair baseline ART adherence (AOR: 10.4; 95% CI:2.4, 44.8), poor baseline ART adherence (AOR: 6.4;95% CI:2.0,20.7), baseline WHO stage III, IV(AOR4.9,95%CI:2.0,11.5), current WHO stage III,IV (AOR: 3.9; 95% CI: 1.1, 13.5), current BMI <18.5 kg/m2 (AOR 2.37 95% CI (1.00, 5.62) and recent low hemoglobin level <12.8 mg/dl (AOR: 4.1; 95% CI:1.7, 9.7) were independently associated with poor quality of life. Key informant interviews identified that financial and food insecurity, stigma and discrimination, poor adherence, and side effect were the predictors that affect the quality of life.Conclusion: Multiple predictors of poor quality of life have been identified from the quantitative and key informant interviews. Khat chewing frequency (occasionally and weekly), stigma, depression, baseline drug adherence, duration on ART(less than 36 months), baseline WHO stage III/IV, Current WHO III, IV, being underweight in the current BMI, most recent hemoglobin level below 12.8mg/dl, including financial and food insecurity, stigma and discrimination, poor adherence and side effect from key informant interview. Therefore, effective interventions should be targeted by incorporating responsible bodies towards boosting the quality of life of PLWHIV by emphasizing avoiding behavioral factors like khat chewing, alcohol, shisha. Counseling and guidance on treatment adherence and follow-up should be done. Continuous awareness creation, dietary diversity, and modifications and guide on income-generating activities.