title: Psychiatric disorders and adherence to antiretroviral therapy among a population of HIV-infected adults in Nigeria.
abstract: Psychiatric disorders are common among people living with HIV in Nigeria. Adherence is necessary to optimise the outcome of antiretroviral therapy. In this study, we aimed to identify associations between antiretroviral adherence, measured by one-week and one-month self-reported missed doses, and psychiatric illness in a cohort previously assessed for psychiatric disorders using the Composite International Diagnostic Interview. The study participants comprised 151 adults with major depression, anxiety or suicidal symptoms, and 302 matched-control participants. Two controls were randomly selected for each case within the same gender and education level. We compared participants with psychiatric disorders (WPDs) and no psychiatric disorders (NPDs) on selected demographic and clinical variables, in addition to adherence. Participants with one or more missed doses in the preceding month had twice the odds of having a major depressive episode as those with no missed doses during this period (OR 2.22, 95% CI 1.03, 4.79). This association remained significant after adjusting for selected risk factors. There was no statistically significant difference between WPD and NPD groups on either one-week or one-month adherence, or on age, marital status, occupational class, HIV viral load at enrolment or current CD4 cell count. Among Nigerian adults with HIV, suboptimal antiretroviral adherence is associated with, and could be a sign of, depression. Routine self-report adherence assessments may potentially be utilised in identifying individuals at risk among this population.
authors.affiliation: Department of Psychiatry, University of Ibadan, Nigeria radejumo@yahoo.com.
authors.forename: Olurotimi
authors.initials: O
authors.lastname: Adejumo
authors.affiliation: Department of Psychiatry, University of Ibadan, Nigeria.
authors.forename: Bibilola
authors.initials: B
authors.lastname: Oladeji
authors.affiliation: Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria.
authors.forename: Onoja
authors.initials: O
authors.lastname: Akpa
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Kay
authors.initials: K
authors.lastname: Malee
authors.affiliation: Department of Psychiatry, University of Ibadan, Nigeria.
authors.forename: Olusegun
authors.initials: O
authors.lastname: Baiyewu
authors.affiliation: Department of Medicine, University of Ibadan, Nigeria.
authors.forename: Adesola
authors.initials: A
authors.lastname: Ogunniyi
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Evans
authors.affiliation: Center for Global Health, Northwestern University, USA.
authors.forename: Baiba
authors.initials: B
authors.lastname: Berzins
authors.affiliation: Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Babafemi
authors.initials: B
authors.lastname: Taiwo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology; D018791:CD4 Lymphocyte Count; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications* / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009549:Nigeria; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; HIV; Nigeria; adherence; antiretroviral therapy; psychiatric disorder