Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study.

Journal: AIDS and behavior

Volume: 27

Issue: 6

Year of Publication: 2023

Affiliated Institutions:  Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse , , Bern, Switzerland. andreas.haas@ispm.unibe.ch. Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse , , Bern, Switzerland. Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa. Medscheme, Cape Town, South Africa. Department of Nuclear Medicine, University of Pretoria, Pretoria, South Africa. Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Psychiatry and New York State Psychiatric Institute, Columbia University, New York, NY, USA. Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa. HIV Mental Health Research Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

Abstract summary 

We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector HIV programme to examine adherence and viral non-suppression (viral load > 400 copies/mL) of participants with (20,743, 38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted risk ratio (aRR) 1.55, 95% confidence interval (CI) 1.22-1.96], substance use disorders (aRR 1.53, 95% CI 1.19-1.97), serious mental disorders (aRR 1.30, 95% CI 1.09-1.54), and depression (aRR 1.19, 95% CI 1.10-1.28) when compared with patients without mental health diagnoses. The risk of viral non-suppression was also higher among males, adolescents (15-19 years), and young adults (20-24 years). Our study highlights the need for psychosocial interventions to improve HIV treatment outcomes-particularly of adolescents and young adults-and supports strengthening mental health services in HIV treatment programmes.

Authors & Co-authors:  Haas Andreas D AD Lienhard Raphael R Didden Christiane C Cornell Morna M Folb Naomi N Boshomane Tebatso M G TMG Salazar-Vizcaya Luisa L Ruffieux Yann Y Nyakato Patience P Wettstein Anja E AE Tlali Mpho M Davies Mary-Ann MA von Groote Per P Wainberg Milton M Egger Matthias M Maartens Gary G Joska John A JA

Study Outcome 

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Statistics
Citations :  Joint United Nations Programme on HIV/AIDS (UNAIDS). AIDSInfo online database. [Internet]. [cited 2022 Apr 10]. Available from: https://aidsinfo.unaids.org/.
Authors :  17
Identifiers
Doi : 10.1007/s10461-022-03916-x
SSN : 1573-3254
Study Population
Male
Mesh Terms
Male
Other Terms
Adherence;Antiretroviral therapy;HIV;Mental disorders;South Africa;Viral suppression
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States