The influence of depression on adherence to antiretroviral therapy among HIV infected patients at Aga Khan University Hospital (Nairobi)
Date of Award
Master of Medicine (MMed)
Internal Medicine (East Africa)
Aim: To determine the influence of depression on adherence to antiretroviral (ARV) therapy among HIV-infected patients.
Design: Cross-sectional survey
Patients: One hundred and forty HIV-positive patients on treatment with Combination Antiretroviral Therapy selected from the out-patient department of Aga Khan University Hospital took part in the survey.
Methodology: Every third patient who was eligible was assessed for adherence to antiretroviral therapy using The Adult AIDS Clinical Trial Group follow up adherence questionnaire followed by screening for depression using the Patient Health Questionnaire 9. Pharmacy data was then retrieved for the same patients and used to assess adherence by the medication possession ratio. The data was then analysed using SPSS and chi square was calculated for relationships between adherence and depression. Odds ratio was also calculated for the risk of depression in the non-adherent group compared to the adherent group.
Results: Fifteen patients did not have any pharmacy data available. Sixty five patients had medication possession ratios of >95% indicating good adherence. Sixty patients had medication possession ratios <95% indicating sub-optimal and poor adherence.30% of non-adherent patients were found to have depressive symptoms as compared to 23% in the adherent group. Although this did not reach significant levels, patients who were non-adherent were 1.3 times more likely to be depressed. On multivariate analysis there was no significant association between depression and levels of adherence.
There was however a significant association between cash payment for medication and higher viral loads (p= 0.029).
Conclusion: This study did not show a significant association between depression and adherence to antiretroviral therapy.
Karanja-Mbugua, E. W. (2011). The influence of depression on adherence to antiretroviral therapy among HIV infected patients at Aga Khan University Hospital (Nairobi) (Unpublished master's dissertation). .
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