உளவியல் & உளவியல் சிகிச்சை இதழ்
திறந்த அணுகல்

சுருக்கம்

Psychosocial Adaptation and ART Adherence of HIV-infected Adults at an Urban Ambulatory Clinic in Uganda

Tom Denis Ngabirano, Joseph Sempa, Amy Bender, Charles Peter Osingada, Patrick Mburugu, Rose Nabirye Chalo, Amsale Cherie and Damalie Nakanjako

Introduction: Success of antiretroviral therapy (ART) requires that individuals maintain nearly one hundred percent adherence to the prescribed regimen. Lack of optimal adherence to ART is associated with a high risk of developing mutant HIV strains, and increased risk of HIV transmission. Psychosocial adaptation is associated with positive health behaviors in HIV. In this study, we determined the correlation between psychosocial adaptation to living with HIV and adherence to ART, and determined the factors associated with psychosocial adaptation.

Methods: In this cross sectional study, we interviewed 235 HIV-infected adults that receive ART from the infectious Diseases Institute (IDI) clinic and used the Health Related Hardiness Scale (HRHS) to measure psychosocial adaptation. Adherence to ART was determined by self-report of the number of doses missed in the previous 7 days. Pearson correlation was used to determine the relationship between psychosocial adaptation and adherence to ART. Logistic regression was used to determine the factors associated with psychosocial adaptation.

Results: Most (60.4%) were females, married or staying with a partner (46.4%) and had some form of employment (74.4%). Participants had a mean age of 38 ± 9 years, had been registered in the HIV clinic for a median period of 6 years, with a mean duration on ART of 4 ± 3 years. A majority (86%) were adherent to ART. HRHS is found to be reliable (Cronbach’s alpha=0.83) and participants had a percentage mean adaptation of 85.9%. There was a significant correlation (r=0.159, p=0.015) between psychosocial adaptation and adherence to ART. Excellent perception of health status (OR=2.36, 95% CI=1.22-4.53, P=0.01), very good self-rating of ART adherence (OR=3.35, 95% CI=1.74-6.50, P=<0.001) and on-time ART doses (OR=2.17, 95% CI=1.06-4.72, P=0.39) were associated with psychosocial adaptation.

Conclusions and recommendations: There was high adherence to ART and good psychosocial adaption to living with HIV in an urban Ugandan HIV cohort. Individuals’ psychosocial adaptation correlated positively with ART adherence levels. Routine assessment of psychosocial adaptation during follow-up of ART-treated adults could be used to identify risk of non-adherence. Longitudinal studies are required to understand ART adherence levels and fluctuations in psychosocial adaptation during daily lived experiences.