Adherence to highly active antiretroviral therapy in depressed patients with HIV/AIDS attending a Nigerian university teaching hospital clinic.
OBJECTIVE
To determine the prevalence of depressive disorder in patients with HIV/AIDS receiving HAART; to determine the effect of depressive disorder on adherence to antiretroviral therapy; and to determine the significance of the association.


METHODS
The study was conducted amongst outpatients of Ahmadu Bello University Teaching Hospital, Zaria. A sociodemographic and drug adherence questionnaire was administered. The Centre for Epidemiological Studies Depression Scale (CES-D) was used to screen for depressive symptoms while the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) was used to confirm the diagnosis of depressive disorder.


RESULTS
A total of 310 patients with HIV/AIDS receiving HAART participated in the study. 68.4% were female and the mean age was 35.5 (± 8.97 years). 37.4% had secondary education, while 27.1% had tertiary education. Sixty-six participants (21.3%) had significant depressive symptoms while 14.2% met ICD-10 diagnostic criteria for depressive disorder. Overall, 73% of participants had good adherence to HAART. 63.6% of participants with depressive disorder had poor adherence to HAART compared to 21.1% of participants without depressive disorder (p<0.05).


CONCLUSIONS
Depressive disorder in patients with HIV/AIDS is associated with poor adherence to antiretroviral medication. Early identification and treatment of depression in such patients may improve antiretroviral medication adherence and treatment outcomes.
Department of Psychiatry, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. olisahvictor@yahoo.com
V O
VO
Olisah
O
O
Baiyewu
T L
TL
Sheikh
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000523:psychology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000523:psychology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009549:Nigeria; D010349:Patient Compliance / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D011795:Surveys and Questionnaires