Reproductive health and lifestyle factors associated with health-related quality of life among perinatally HIV-infected adolescents in Uganda.
BACKGROUND
With increased survival of perinatally HIV - infected adolescents due to antiretroviral therapy (ART), the focus of HIV care has shifted to health-related quality of life (HRQoL) as a measure of disease progression, effects of ART co-morbidity and prognosis. We assessed factors associated with better HRQoL in perinatally HIV -infected adolescents in Uganda by determining the associations between sexual and reproductive health (SRH) or lifestyle experiences on HRQoL.


METHODS
In a cross-sectional study, data on SRH, lifestyle experiences, socio demographic factors, communication with parents on sexuality and satisfaction of SRH services in ART clinics were collected from 614 HIV perinatally infected adolescents aged 10-19 using an interviewer-administered survey questionnaire. HRQoL data were collected using the Medical Outcomes Study HIV Health Survey instrument (MOS-HIV). Factors associated with better HRQoL were analysed using multiple logistic regression.


RESULTS
The mean age was 16.2 ± 2.1 years, 362 (58.8 %) were females and 210 (34.2 %) were sexually active. Adolescents on ART were twice likely to present with better physical health (AOR = 2.07, 95 % CI: 1.24-3.46) and four times more likely to present with better mental health (AOR = 3.9, 95 % CI: 2.22-6.92) than those who were not on ART. There were no statistically significant associations between SRH (ever had sex, ever been pregnant, condom use, contraceptive use) or life style factors and physical health or mental health. Those with secondary or tertiary education were more likely to present with a better mental health (AOR = 5.3, 95 % CI: 1.86-15.41) compared those who had attained primary or no education. Participants who desired to have a child in future more likely (AOR 1.7, 95 % CI: 1.05-3.00) to present with a better mental health. Lack of communication with guardians on sexuality (AOR = 0.6, 95 % CI: 0.40-0.89), or dissatisfaction with SRH services (AOR 0.34, 95 % CI: 0.18-0.62) were associated with poorer mental health.


CONCLUSIONS
Among perinatally HIV-infected adolescents in Uganda, being on ART was associated with better physical and mental health while lack of communication with guardians on sexuality or dissatisfaction with SRH services was associated with poor mental health. Adolescents with pregnancy intentions were more likely to have a better mental health.
Department of Nursing, School of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Uganda. snmbalinda@gmail.com.
Scovia Nalugo
SN
Mbalinda
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. nkiwanuka@gmail.com.
Noah
N
Kiwanuka
Department of Obstetrics and Gynecology, College of Health Sciences, Makerere University, Kampala, Uganda. dankkaye@yahoo.com.
Dan K
DK
Kaye
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden. Lars.Eriksson@ki.se.|Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. Lars.Eriksson@ki.se.|School of Health Sciences, City University London, London, UK. Lars.Eriksson@ki.se.
Lars E
LE
Eriksson
D000293:Adolescent; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000151:congenital* / Q000635:transmission*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008019:Life Style; D016015:Logistic Models; D008297:Male; D010290:Parents; D011788:Quality of Life; D060728:Reproductive Health / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult