Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Medicine
Abstract
: The impact of psychosocial status at onset of antiretroviral
therapy on changes in quality of life (QOL) and subjectively rated health
(SRH) among adults on ART in resource-limited settings is poorly
understood. Therefore, we evaluate the association between stigma,
anxiety, depression, and social support and change in QOL and SRH in
HIV-infected Ugandan adults during an 18-month period.
Psychosocial indicators were assessed at enrollment using structured
questionnaires. QOL and SRH measures were assessed at months 0, 6, 12,
and 18 using the Medical Outcomes Survey-HIV. Linear mixed models
determined risk estimated differences in QOL and SRH in relation to
quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences inlikelihood ofimproved versus nonimproved SRH during follow-up.
QOL scores and SRH improved significantly for all participants over 18
months (P< 0.0001). The gain in QOL increased dose-dependently as
baseline depressive symptoms (time
depression P< 0.001) and
anxiety levels (time
anxiety P< 0.001) declined. Lower social
support was associated with worse QOL at baseline (P¼ 0.0005)
but QOL improvement during follow-up was not dependent on
baseline level of social support (time
social support P¼ 0.8943)
or number of stigmatizing experiences (time
stigma P¼ 0.8662).
Psychosocial determinants did not predict changes in SRH in this
study.
High levels of depression and anxiety symptoms at HAART initiation
predicts lower gains in QOL for HIV-positive patients for as long as 18
months. Long-term QOL improvements in HIV-infected adults may be
enhanced by implementation of psychosocial interventions to reduce
depression and anxiety in HIV-infected adults
Description
Keywords
Anxiety Symptoms, Quality, Life Deficits, HIV-Positive Ugandan Adults, Antiretroviral Therapy
Citation
Ezeamama, A. E., Woolfork, M. N., Guwatudde, D., Bagenda, D., Manabe, Y. C., Fawzi, W. W., & Fawzi, M. C. S. (2016). Depressive and anxiety symptoms predict sustained quality of life deficits in HIV-positive Ugandan adults despite antiretroviral therapy: a prospective cohort study. Medicine, 95(9). DOI: 10.1097/MD.0000000000002525