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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Trauma History and Depression Predict Incomplete Adherence to Antiretroviral Therapies in a Low Income Country
PLoS ONE, Volume 8, No. 10, Article e74771, Year 2013
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Description
Background:As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care.Methodology:The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV clinics and four free-standing voluntary HIV counselling and testing sites. Baseline data were collected in 2008 and 2009; this paper used data from 36 month follow-up interviews (N = 468). Regression analyses were used to predict factors associated with incomplete self-reported adherence to ART.Results:Incomplete ART adherence was significantly more likely to be reported amongst participants who experienced a greater number of childhood traumatic events: sexual abuse prior to puberty and the death in childhood of an immediate family member not from suicide or homicide were significantly more likely in the non-adherent group and other negative childhood events trended toward being more likely. Those with incomplete adherence had higher depressive symptom severity and post-traumatic stress disorder (PTSD). In multivariable analyses, childhood trauma, depression, and financial sacrifice remained associated with incomplete adherence.Discussion:This is the first study to examine the effect of childhood trauma, depression and PTSD on HIV medication adherence in a low income country facing a significant burden of HIV. Allocating spending on HIV/AIDS toward integrating mental health services with HIV care is essential to the creation of systems that enhance medication adherence and maximize the potential of expanded antiretroviral access to improve health and reduce new infections. © 2013 Whetten et al.
Authors & Co-Authors
Whetten, Kathryn D.
United States, Durham
Duke University
Shirey, Kristen
United States, Durham
Duke University
Pence, Brian Wells
United States, Durham
Duke University
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Yao, Jia
United States, Durham
Duke University
Thielman, Nathan M.
United States, Durham
Duke University
Whetten, Rachel A.
United States, Durham
Duke University
Adams, Julie L.
United States, Durham
Duke University
Agala, Bernard
United States, Durham
Duke University
Ostermann, Jan
United States, Durham
Duke University
O'Donnell, Karen
United States, Durham
Duke University
Hobbie, Amy
United States, Durham
Duke University
Maro, Venance Phillip
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Itemba, Dafrosa K.
Tanzania
Tanzania Women Research Foundation
Reddy, Elizabeth A.
United States, Durham
Duke University
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Lema, Beatrice
Unknown Affiliation
Madukwa, Yombya
Unknown Affiliation
Mvungi, Restituta
Unknown Affiliation
Mrema, Amiri
Unknown Affiliation
Ricky, Wendy
Unknown Affiliation
Samora, Ludovic
Unknown Affiliation
Zenze, Blandina
Unknown Affiliation
Hamilton, Kyle
Unknown Affiliation
Statistics
Citations: 69
Authors: 22
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0074771
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Mental Health
Sexual And Reproductive Health
Violence And Injury
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Tanzania