Prevalence, burden, and correlates of physical and psychological symptoms among HIV palliative care patients in sub-Saharan Africa: an international multicenter study.
BACKGROUND
Despite HIV remaining life limiting and incurable, very little clinical research focus has been given to the prevalence and related burden of physical and psychological symptoms for those accessing palliative care. Despite evidence of problems persisting throughout the trajectory and alongside treatment, scant attention has been paid to these manageable problems.


OBJECTIVE
This study aimed to measure the seven-day period prevalence and correlates of physical and psychological symptoms, and their associated burden, in HIV-infected individuals attending palliative care centers in sub-Saharan Africa.


METHODS
Consecutive patients in five care centers across two countries completed the Memorial Symptom Assessment Scale-Short Form, with additional demographic and disease-oriented variables.


RESULTS
Two hundred twenty-four patients participated. The most common symptoms were pain in the physical dimension (82.6%) and worry in the psychological dimension (75.4%). Interestingly, 71.4% reported hunger. Women, and those with worse physical function, were more likely to experience burden. However, being on antiretroviral therapy (ART) was not associated with global, physical, or psychological symptom burden.


CONCLUSIONS
This study is the first to report physical and psychological symptom burden in HIV-infected populations receiving palliative care in sub-Saharan Africa. Despite increasing access to ART, these burdensome and manageable problems persist. The assessment of these problems is essential alongside assessment of ART virological outcomes.
Department of Palliative Care, Policy, and Rehabilitation and The Cicely Saunders Institute of Palliative Care, King's College London, London, United Kingdom. richard.harding@kcl.ac.uk
Richard
R
Harding
Lucy
L
Selman
Godfrey
G
Agupio
Natalya
N
Dinat
Julia
J
Downing
Liz
L
Gwyther
Thandi
T
Mashao
Keletso
K
Mmoledi
Tony
T
Moll
Lydia Mpanga
LM
Sebuyira
Barbara
B
Ikin
Irene J
IJ
Higginson
D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D010147:Pain Measurement; D010166:Palliative Care; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology*