Mental health disorders and substance use among people living with HIV in Nepal: their influence on non-adherence to anti-retroviral therapy.

Journal: AIDS care

Volume: 31

Issue: 8

Year of Publication: 2020

Affiliated Institutions:  a Integrated Development Foundation Nepal , Kathmandu , Nepal. b Department Psychiatry and Mental Health , Institute of Medicine, Tribhuwan University , Kathmandu , Nepal. c Department of Health Promotion and Policy , School of Public Health and Health Sciences, University of Massachusetts , Amherst , MA , USA. d Management and Development for Health , Dar es Salaam , Tanzania. e Department of Community and Global Health , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan.

Abstract summary 

People living with HIV often experience mental health disorders and engage in substance use. Evidence, however, is limited about the influence of mental health disorders and substance use on non-adherence to ART. We conducted a cross-sectional study among 682 HIV-positive people on ART in Nepal. We measured their depressive symptoms, anxiety, stress levels, substance use, and non-adherence to ART. We developed logistic regression models to examine the association of mental health disorders and substance use with non-adherence to ART. Experiencing depressive symptoms was positively associated with ART non-adherence among HIV-positive people (men: AOR = 2.77,  = .001; women: AOR = 3.69,  = .001). Additionally, both men and women were more likely to have non-adherence to ART when they had anxiety (men: AOR = 2.19,  = .022; women AOR = 2.83,  = .001) and higher stress scores (men: AOR = 1.11,  = .001; women: AOR = 1.08,  = .001). While substance use was associated with non-adherence only in HIV-positive men (AOR = 3.12,  < .001). Depressive symptoms, anxiety, and high level of stress had negative roles on adherence in HIV-positive men and women. While substance use had a negative role on ART adherence among men only. Results highlight that the HIV-positive people should be screened and provided treatment and psychosocial support while providing ART services to improve their medication adherence.

Authors & Co-authors:  Pokhrel Khem Narayan KN Pokhrel Kalpana Gaulee KG Sharma Vidya Dev VD Poudel Krishna Chandra KC Neupane Sanjeev Raj SR Mlunde Linda Beatrice LB Jimba Masamine M

Study Outcome 

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Statistics
Citations : 
Authors :  7
Identifiers
Doi : 10.1080/09540121.2019.1587365
SSN : 1360-0451
Study Population
Men,Women
Mesh Terms
Adolescent
Other Terms
HIV;Mental health;Nepal;anti-retroviral therapy;substance use
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England