Depression and patterns of self-reported adherence to antiretroviral therapy in Rwanda.

Journal: International journal of STD & AIDS

Volume: 26

Issue: 4

Year of Publication: 2015

Affiliated Institutions:  Department of Internal Medicine, Brigham & Women's Hospital, Boston, MA, USA Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda ewroe@partners.org. Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA University of Rwanda College of Medicine and Health Sciences, Butare, Rwanda. Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Institute of HIV Disease Prevention and Control, Rwanda Biomedical Center, Kigali, Rwanda. Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda. Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda Division of Global Health Equity, Brigham & Women's Hospital, Boston, MA, USA.

Abstract summary 

We determined the prevalence of depression in HIV-infected adults on antiretroviral therapy in rural Rwanda and measured the association of depression with non-adherence. In all, 292 patients on antiretroviral therapy for ≥6 months were included. Adherence was self-reported by four-day recall, two- and seven-day treatment interruptions, and the CASE Index, which is a composite score accounting for difficulty taking medications on time, the average number of days per week a dose is missed, and the most recent missed dose. A total of 84% and 87% of participants reported good adherence by the four-day recall and CASE Index, respectively; 13% of participants reported two-day treatment interruptions; and 11% were depressed. Depression was significantly associated with two-day treatment interruptions but not with other measures of non-adherence. Self-reported adherence to antiretroviral therapy in rural Rwanda is high. Adherence assessments that do not consider treatment interruptions may miss important patterns of non-adherence, which may be especially prevalent among depressed individuals. Mental health interventions incorporated into routine HIV care may lead to improvements in mental health and adherence.

Authors & Co-authors:  Wroe Emily B EB Hedt-Gauthier Bethany L BL Franke Molly F MF Nsanzimana Sabin S Turinimana Jean Bosco JB Drobac Peter P

Study Outcome 

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Citations : 
Authors :  6
Identifiers
Doi : 10.1177/0956462414535206
SSN : 1758-1052
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
AIDS;Africa;HIV;adherence;antiretroviral therapy;depression;screening;treatment;viral disease
Study Design
Study Approach
Country of Study
Rwanda
Publication Country
England