Association between ART adherence and mental health: results from a national HIV sero-behavioural survey in South Africa

SOURCE: AIDS and Behavior
OUTPUT TYPE: Journal Article
TITLE AUTHOR(S): E.Marinda, N.Zungu, J.Chikovore, J.Mthembu, M.Magampa, Q.Mathentamo, C.O.Nwosu, P.Maoba, S.Ramlagan, K.Zuma, S.Moyo, L.Simbayi
DEPARTMENT: Public Health, Societies and Belonging (HSC), Impact Centre (IC), Impact Centre (PRESS), Impact Centre (CC), Deputy CEO: Research (DCEO_R), Deputy CEO: Research (ERKC), Deputy CEO: Research (CGI)
Print: HSRC Library: shelf number 9812295
HANDLE: 20.500.11910/19281

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This paper assesses the levels of antiretroviral treatment (ART) adherence and mental health distress among study participants in a national behavioural HIV-Sero prevalence study South Africa. The study was a cross-sectional population-based multi-stage stratified cluster random survey, (SABSSM V, 2017). Structured questionnaires were used to collect information on socio-demographics, HIV knowledge, perceptions, HIV testing and HIV treatment history. Study participants were tested for HIV infection, antiretroviral use, viral suppression, and ART drug resistance. A total of 2155 PLHIV aged 15 years or older who were on ART were included in the study. Incidence of either moderate or severe mental health distress was 19.7%. Self-reported ART adherence among study participants with no, mild, moderate, or severe mental distress was 82%, 83%, 86% and 78%, respectively. The adjusted odds ratio for ART non-adherence was 0.58 (95% CI 0.24; 1.40) for mild mental distress, 0.82 (95% CI 0.35; 1.91) for moderate mental distress and 2.19 (95% CI 1.14; 4.19) for severe mental distress groups compared to the no mental health distress group. The other factors that were associated with ART non-adherence in adjusted models included education level, alcohol use and province/region of residence. The study revealed that mental health remains a challenge to ART adherence in South Africa. To improve ART adherence, HIV continuum of care programs should include screening for mental health among people living with HIV.