Quality of life and adherence to HAART in HIV-Infected patients in a primary healthcare setting in South Africa

Abstract

The use of Antiretroviral therapy (ART) in HIV-infected patients has reduced HIV-associated morbidity and mortalityincreasing life-expectancy and expected improved quality of life (QoL). There is a need to assess QoL and adherence to ART in people with HIV.A cross-sectional study was performed on 100 patients of ≥18years. A Standardized-Questionnaire with face-to-face interviews was used to collect sociodemographic data and ART-adherence determined using a pill-count method considering ≥90% acceptable. QoL was assessed using a WHOQOL-HIV BREF questionnaire using a 5 point-Likert scale. Data were analysed using SPSS 22 calculating descriptive-statistics such as mean, standard-deviation, mean-scores. Correlations and ANOVA were performed to determine significant differences between domain-scores. Post-hoc analysis was performed using Tukey’s to find out pairs contributing to the differences. Of 100 interviewed, 63% were females and 37% males with mean-age of 38.0years (range 18-53 years). The highest (36%) were in age-range of 31-40 years, 47% obtained secondary-level of education, 20% employed on contracts and 32% received <ZAR10000 monthly and 55% living in rural-areas. Forty-two percent were singles. The majority (92%) reported good physicalhealth-status. More than half (72%) had initial CD4⁺count≥500 cells/mm³, with 54% having initial viral-load of >10000 copies/mL and 98% undetectable viral-load. Seventy-one percent reported being infected with men. Sixty-two percent were asymptomatic and (43%) WHO clinical-stage 2. Only 24% had acceptable adherence-rate of ≥90%. The highest mean-scores (77.00±14.94) were in the environmental and lowest (26.25±26.44) in spiritual/religious/personal beliefsdomains (SRPB). The highest mean-scores of acceptable ART-adherence was in Social (81.25±15.19) with least in SRPB (22.92±26.49) domains. Statistical significances were between acceptable adherence-rates and level-of-independence and psychological domains with F=5.823, p=0.018 and F=3.690, p=0.050 respectively.Adherence to ART leads to improved QoL, key-determinant of patient’s response to treatment. Measuring QoL gives guidance strategies to develop implementation interventions focusing on enhancing QoL, improving healthcare provider-patient-communication thus improving quality-of-care.