The Effect of Psychological Distress on Medication Adherence in Persons With HIV Infection in Nigeria

Adewuya, Abiodun O.; Afolabi, Muhammed O.; Ola, Bolanle; Ogundele, Olorunfemi Akinbode; Ajibare, Adeola O.; Oladipo, Bamidele F.; Fakande, Ibiyemi

doi:10.1176/appi.psy.51.1.68

Cited by 18 publications

(13 citation statements)

References 21 publications

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“…Most significant findings refer to a positive association between levels of SES components and levels of adherence to antiretroviral treatment, although one for income (59), four for education (21,31,43,63) and two for employment (59,77) of the reviewed studies suggest an inverse association with adherence. However, the aforementioned SES determinants were not found to be significantly associated with adherence in relation to 20 income-related studies (71,73,23,24,25,30,34-36,42,43,45,57,61,77), 35 education-related studies (22-25,27,29,32,34,36,38,42,44,45,47-52,60,64,67,70,74,76,78-81,82), 22 employment/occupational status-related studies (22-24,34-36,41,42,44,45,49,53,54,58,67-70,78,79,81,82) and two SES-related studies (40,78) (Table 2). …”

Section: Resultsmentioning

confidence: 89%

Socioeconomic Factors in Adherence to HIV Therapy in Low- and Middle-income Countries

Peltzer

Pengpid

2013

J Health Popul Nutr

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It is not clear what effect socioeconomic factors have on adherence to antiretroviral therapy (ART) among patients in low- and middle-income countries. We performed a systematic review of the association of socioeconomic status (SES) with adherence to treatment of patients with HIV/AIDS in low- and middle-income countries. We searched electronic databases to identify studies concerning SES and HIV/AIDS and collected data on the association between various determinants of SES (income, education, occupation) and adherence to ART in low- and middle-income countries. From 252 potentially-relevant articles initially identified, 62 original studies were reviewed in detail, which contained data evaluating the association between SES and adherence to treatment of patients with HIV/AIDS. Income, level of education, and employment/occupational status were significantly and positively associated with the level of adherence in 15 studies (41.7%), 10 studies (20.4%), and 3 studies (11.1%) respectively out of 36, 49, and 27 studies reviewed. One study for income, four studies for education, and two studies for employment found a negative and significant association with adherence to ART. However, the aforementioned SES determinants were not found to be significantly associated with adherence in relation to 20 income-related (55.6%), 35 education-related (71.4%), 23 employment/occupational status-related (81.5%), and 2 SES-related (100%) studies. The systematic review of the available evidence does not provide conclusive support for the existence of a clear association between SES and adherence to ART among adult patients infected with HIV/AIDS in low- and middle-income countries. There seems to be a positive trend among components of SES (income, education, employment status) and adherence to antiretroviral therapy in many of the reviewed studies.

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Section: Resultsmentioning

confidence: 89%

Socioeconomic Factors in Adherence to HIV Therapy in Low- and Middle-income Countries

Peltzer

Pengpid

2013

J Health Popul Nutr

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“… 67 82 84 94 110 116 122 144 Conversely, difficulty in coming to terms and lack of belief in existence of HIV, and not feeling sick were barriers to adherence. 3 33 Other determinants affecting both adherence and non-adherence were cognitive impairment, 73 128 143 internalised stigma, 43 68 73 82 known use of ART and/or HIV status of others, 47 49 69 72 134 139 psychological distress, 72 150 trauma, 109 142 151 masculinity, 85 122 152 sharing medication, 35 94 lack of commitment to therapy, 63 85 105 119 120 isolation from family, 115 caring for family, 114 121 wanting to return to life before ART, 119 being accused of infecting others, 102 psychiatric care service 126 and stress. 83 …”

Section: Resultsmentioning

confidence: 99%

Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: a systematic review

et al. 2016

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ObjectiveThe rapid scale up of antiretroviral treatment (ART) in sub-Saharan Africa (SSA) has resulted in an increased focus on patient adherence. Non-adherence can lead to drug-resistant HIV caused by failure to achieve maximal viral suppression. Optimal treatment requires the identification of patients at high risk of suboptimal adherence and targeted interventions. The aim of this review was to identify and summarise determinants of adherence to ART among HIV-positive adults.DesignSystematic review of adherence to ART in SSA from January 2002 to October 2014.MethodsA systematic search was performed in 6 databases (PubMed, Cochrane Library, EMBASE, Web of Science, Popline, Global Health Library) for qualitative and quantitative articles. Risk of bias was assessed. A meta-analysis was conducted for pooled estimates of effect size on adherence determinants.ResultsOf the 4052 articles screened, 146 were included for final analysis, reporting on determinants of 161 922 HIV patients with an average adherence score of 72.9%. Main determinants of non-adherence were use of alcohol, male gender, use of traditional/herbal medicine, dissatisfaction with healthcare facility and healthcare workers, depression, discrimination and stigmatisation, and poor social support. Promoters of adherence included counselling and education interventions, memory aids, and active disclosure among people living with HIV. Determinants of health status had conflicting influence on adherence.ConclusionsThe sociodemographic, psychosocial, health status, treatment-related and intervention-related determinants are interlinked and contribute to optimal adherence. Clinics providing ART in SSA should therefore design targeted interventions addressing these determinants to optimise health outcomes.

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“…After review of the title and abstract 134 full text articles were selected for critical reading. A total of 111 studies [22–77, 10, 78–98, 6, 99–130] that recruited 42,366 PLHIV met the inclusion criteria. Table 1 shows the characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

Depression and Adherence to Antiretroviral Therapy in Low-, Middle- and High-Income Countries: A Systematic Review and Meta-Analysis

et al. 2014

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We investigated the associations between depressive symptoms and adherence to antiretroviral therapy (ART) among people living with HIV (PLHIV). We searched the PubMed, EMBASE and Cochrane CENTRAL databases for studies that studies that reported an association between depression and adherence to ART as a primary or secondary outcome. We used a random-effect model to pool the risk estimates from the individual studies. The odds ratio (OR) with their 95% CIs were used as summary estimates. Of 2,861 citations, 111 studies that recruited 42,366 PLHIV met our inclusion criteria. When reported, the rate of PLHIV with depressive symptoms ranged from 12.8% to 78% and the proportion of PLHIV who achieved good adherence (≥ 80%) ranged from 20% to 98%. There were no significant differences in rate of depressive symptoms in PLHIV by country income group; however, the proportion of PLHIV who achieved good adherence was significantly higher in lower-income countries (as defined in the 2012 World Bank Country Income Groups) (pooled rate = 86%) compared to higher-income countries (pooled rate = 67.5%; p<.05). We found that the likelihood of achieving good ART adherence was 42% lower among those with depressive symptoms compared to those without (pooled OR = 0.58, 95% CI 0.55 to 0.62). The relationship between depressive symptoms and adherence to ART was consistent across the country’s income group, study design, and adherence rates. We found that the magnitude of the association significantly decreases with more recent publications and increasing study sample size. The higher the prevalence of depressive symptoms of PLHIV recruited in the studies, the lower the likelihood of achieving good adherence to ART. In conclusion, the likelihood of achieving good adherence was lower among those with depressive symptoms compared to those without.

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The Effect of Psychological Distress on Medication Adherence in Persons With HIV Infection in Nigeria

Cited by 18 publications

References 21 publications

Socioeconomic Factors in Adherence to HIV Therapy in Low- and Middle-income Countries

Socioeconomic Factors in Adherence to HIV Therapy in Low- and Middle-income Countries

Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: a systematic review

Depression and Adherence to Antiretroviral Therapy in Low-, Middle- and High-Income Countries: A Systematic Review and Meta-Analysis

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