Psychological distress and adherence to highly active anti-retroviral therapy (HAART) in Uganda: a pilot study.
BACKGROUND
Mental health related risk factors for non-adherence to highly active anti-retroviral therapy (HAART) have not been investigated in Uganda and yet adherence is critical to the success of the current scale up in the provision of HAART to HIV positive individuals in rural areas of Uganda.


OBJECTIVE
To determine whether psychological distress is a risk factor for non-adherence to HAART among HIV positive individuals.


METHODS
One hundred twenty-two HIV positive adult individuals receiving care from an Urban HIV clinic were enrolled in the study. Participants were screened for psychological distress with the Self Report Questionnaire (SRQ-20). Adherence was assessed using the self report method. Multivariate logistic regression analysis was used to determine whether psychological distress is a risk factor for non-adherence to HAART adjusting for various socio-demographic and clinical factors.


RESULTS
Psychological distress and living in isolation were significantly associated with non-adherence to HAART after adjusting for other demographic and clinical variables [OR=3.66, 95%CI (1.39 - 9.78) and OR=9.80, 95%CI (2.27 - 18.70)] respectively. Among HIV positive individuals who were receiving additional treatment for a mental disorder, psychological distress was not significantly associated with non-adherence to HAART [OR= 1.25, 95%CI (0.30 - 5.20)]


CONCLUSIONS
Regular screening and management of psychological distress may prevent further complications in HIV positive individuals in Uganda.
Nakimuli-Mpungu
Etheldreda
E
Makerere Univerity College of Health Sciences, School of Medicine, Department of Psychiatry, P. O. Box 7072 Kampala, Uganda. enakimul@jhsph.edu
Mutamba
Brian
B
Othengo
Makanga
M
Musisi
Seggane
S
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000150:complications / Q000209:etiology; D008875:Middle Aged; D010865:Pilot Projects; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult