Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study
Abstract Introduction Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders. Methods This...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-023-04782-0 |
| _version_ | 1797840892214640640 |
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| author | Flavio M. Mandlate M. Claire Greene Luis F. Pereira Maria Lidia Gouveia Jair Jesus Mari Francine Cournos Cristiane S. Duarte Maria A. Oquendo Marcelo Feijó Mello Milton L. Wainberg |
| author_facet | Flavio M. Mandlate M. Claire Greene Luis F. Pereira Maria Lidia Gouveia Jair Jesus Mari Francine Cournos Cristiane S. Duarte Maria A. Oquendo Marcelo Feijó Mello Milton L. Wainberg |
| author_sort | Flavio M. Mandlate |
| collection | DOAJ |
| description | Abstract Introduction Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders. Methods This study assessed the association of multiple mental disorders and adherence to ART based on the data from primary/tertiary health care facilities in Maputo and Nampula, Mozambique. We administered a sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI) Plus 4.0.0 adapted for use in Mozambique to assess mental conditions, and a 3-item self-report to measure ART adherence. Results 395 HIV-positive (self-report) participants on ART, with an average age of 36.7 years (SD = 9.8), and 30.4% were male. The most common mental disorders were major depressive disorder (27.34%) followed by psychosis (22.03%), suicidal ideation/behavior (15.44%), and alcohol-use disorder (8.35%). Higher odds of missing at least one dose in the last 30 days (OR = 1.45, 95% CI: 1.01, 2.10) were found in participants with any mental disorder compared to those without a mental disorder. The highest levels of non-adherence were observed among those with drug use disorders and panic disorder. Conclusions In Mozambique, PWH with any co-occurring mental conditions had a lower probability of ART adherence. Integrating comprehensive mental health assessment and treatment and ART adherence interventions tailored to PWH with co-occurring mental disorders is necessary to attain optimal ART adherence and reach the UNAIDS ART target. |
| first_indexed | 2024-04-09T16:22:08Z |
| format | Article |
| id | doaj.art-ef689d384753420398ff019c11685d35 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-09T16:22:08Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-ef689d384753420398ff019c11685d352023-04-23T11:24:55ZengBMCBMC Psychiatry1471-244X2023-04-0123111110.1186/s12888-023-04782-0Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional studyFlavio M. Mandlate0M. Claire Greene1Luis F. Pereira2Maria Lidia Gouveia3Jair Jesus Mari4Francine Cournos5Cristiane S. Duarte6Maria A. Oquendo7Marcelo Feijó Mello8Milton L. Wainberg9Department of Mental Health, Ministry of HealthProgram on Forced Migration and Health, Department of Population and Family Health, Columbia University Mailman School of Public HealthNew York State Psychiatric Institute, Columbia UniversityDepartment of Mental Health, Ministry of HealthDepartment of Psychiatry, Federal University of Sao PauloNew York State Psychiatric Institute, Columbia UniversityNew York State Psychiatric Institute, Columbia UniversityPerelman School of Medicine, University of PennsylvaniaDepartment of Psychiatry, Federal University of Sao PauloNew York State Psychiatric Institute, Columbia UniversityAbstract Introduction Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders. Methods This study assessed the association of multiple mental disorders and adherence to ART based on the data from primary/tertiary health care facilities in Maputo and Nampula, Mozambique. We administered a sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI) Plus 4.0.0 adapted for use in Mozambique to assess mental conditions, and a 3-item self-report to measure ART adherence. Results 395 HIV-positive (self-report) participants on ART, with an average age of 36.7 years (SD = 9.8), and 30.4% were male. The most common mental disorders were major depressive disorder (27.34%) followed by psychosis (22.03%), suicidal ideation/behavior (15.44%), and alcohol-use disorder (8.35%). Higher odds of missing at least one dose in the last 30 days (OR = 1.45, 95% CI: 1.01, 2.10) were found in participants with any mental disorder compared to those without a mental disorder. The highest levels of non-adherence were observed among those with drug use disorders and panic disorder. Conclusions In Mozambique, PWH with any co-occurring mental conditions had a lower probability of ART adherence. Integrating comprehensive mental health assessment and treatment and ART adherence interventions tailored to PWH with co-occurring mental disorders is necessary to attain optimal ART adherence and reach the UNAIDS ART target.https://doi.org/10.1186/s12888-023-04782-0Mental disordersART adherenceHIV/AIDS treatmentMozambique |
| spellingShingle | Flavio M. Mandlate M. Claire Greene Luis F. Pereira Maria Lidia Gouveia Jair Jesus Mari Francine Cournos Cristiane S. Duarte Maria A. Oquendo Marcelo Feijó Mello Milton L. Wainberg Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study BMC Psychiatry Mental disorders ART adherence HIV/AIDS treatment Mozambique |
| title | Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study |
| title_full | Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study |
| title_fullStr | Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study |
| title_full_unstemmed | Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study |
| title_short | Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study |
| title_sort | association between mental disorders and adherence to antiretroviral treatment in health facilities in two mozambican provinces in 2018 a cross sectional study |
| topic | Mental disorders ART adherence HIV/AIDS treatment Mozambique |
| url | https://doi.org/10.1186/s12888-023-04782-0 |
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