Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

HIV Infections*/complications ; HIV Infections*/drug therapy ; HIV Infections*/epidemiology ; Depressive Disorder, Major*/complications ; Mental Disorders*/complications ; Mental Disorders*/drug therapy ; Mental Disorders*/epidemiology; Humans ; Male ; Adult ; Female ; Cross-Sectional Studies ; Mozambique/epidemiology ; Health Facilities ; Medication Adherence/psychology

Introduction: Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders.
Methods: This study assessed the association of multiple mental disorders and adherence to ART based on the data from primary/tertiary health care facilities in Maputo and Nampula, Mozambique. We administered a sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI) Plus 4.0.0 adapted for use in Mozambique to assess mental conditions, and a 3-item self-report to measure ART adherence.
Results: 395 HIV-positive (self-report) participants on ART, with an average age of 36.7 years (SD = 9.8), and 30.4% were male. The most common mental disorders were major depressive disorder (27.34%) followed by psychosis (22.03%), suicidal ideation/behavior (15.44%), and alcohol-use disorder (8.35%). Higher odds of missing at least one dose in the last 30 days (OR = 1.45, 95% CI: 1.01, 2.10) were found in participants with any mental disorder compared to those without a mental disorder. The highest levels of non-adherence were observed among those with drug use disorders and panic disorder.
Conclusions: In Mozambique, PWH with any co-occurring mental conditions had a lower probability of ART adherence. Integrating comprehensive mental health assessment and treatment and ART adherence interventions tailored to PWH with co-occurring mental disorders is necessary to attain optimal ART adherence and reach the UNAIDS ART target.
(© 2023. The Author(s).)

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R01 AA025947 United States AA NIAAA NIH HHS; T32 MH096724 United States MH NIMH NIH HHS; U19 MH113203 United States MH NIMH NIH HHS; D43 TW009675 United States TW FIC NIH HHS; K01 MH129572 United States MH NIMH NIH HHS

Keywords: ART adherence; HIV/AIDS treatment; Mental disorders; Mozambique

Date Created: 20230420 Date Completed: 20230424 Latest Revision: 20240321

20240321

PMC10116733

10.1186/s12888-023-04782-0

37081470