title: HIV-related symptoms and management in HIV and antiretroviral therapy patients in KwaZulu-Natal, South Africa: a longitudinal study.
abstract: OBJECTIVE
  The study aimed to determine the prevalence, predictors, and self-reported management of HIV- or ARV-related symptoms among HIV patients prior to antiretroviral therapy (ART) and over three time points while receiving ART in KwaZulu-Natal, South Africa.
  
  
  METHODS
  A total of 735 consecutive patients (29.8% male and 70.2% female) who attended three HIV clinics completed assessments prior to ARV initiation, 519 after 6 months, 557 after 12 months, and 499 after 20 months on ART.
  
  
  RESULTS
  The HIV patients reported an average of 7.5 symptoms (prior to ART), 1.2 symptoms after 6 months on ART, 0.3 symptoms after 12 months on ART, and 0.2 symptoms after 20 months on ART on the day of the interview, with a higher symptom frequency amongst patients who were not employed, had lower CD4 cell counts, experienced internalised stigma, and used alcohol. The most common symptoms or conditions identified by the self-report included tuberculosis, diarrhoea, headaches, rash, nausea and vomiting, pain, neuropathy, lack of appetite, cough, and chills. Overall, the participants reported medications as the most frequently occurring management strategy, with the second being spiritual, and the third being complementary or traditional treatments. The use of all other management strategies decreased over the four different assessment periods from prior to ART to 20 months on ART.
  
  
  CONCLUSIONS
  This study found a high symptom burden among HIV patients, which significantly decreased with progression on antiretroviral treatment. Several symptoms that persisted over time and several sociodemographic factors were identified that can guide symptom management. The utilisation of different symptom management strategies (medical, spiritual, complementary, and traditional) should be taken into consideration in HIV treatment.
authors.affiliation: a PhD, Research Director, Research Programme HIV/AIDS, STI, and TB (HAST), Human Sciences Research Council , South Africa.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D023341:Chills / Q000453:epidemiology; D003371:Cough / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D005076:Exanthema / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006261:Headache / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D057545:Social Stigma; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology
chemical_list: D019380:Anti-HIV Agents