Reproductive Health & Lifestyle Factors associated with Health-Related Quality of Life among Perinatally HIV-Infected Adolescents in Uganda

With increased survival of perinatally HIV - infected adolescents due to antiretroviral therapy (ART), the focus of HIV care has shifted to health-related quality of life (HRQoL) as a measure of disease progression, effects of ART co-morbidity and prognosis. We assessed factors associated with better HRQoL in perinatally HIV -infected adolescents in Uganda by determining the associations between sexual and reproductive health (SRH) or lifestyle experiences on HRQoL.

In a cross-sectional study, data on SRH, lifestyle experiences, socio demographic factors, communication with parents on sexuality and satisfaction of SRH services in ART clinics were collected from 614 HIV perinatally infected adolescents aged 10-19 using an interviewer-administered survey questionnaire. HRQoL data were collected using the Medical Outcomes Study HIV Health Survey instrument (MOS-HIV). Factors associated with better HRQoL were analysed using multiple logistic regression.

The mean age was 16.2 ± 2.1 years, 362 (58.8 %) were females and 210 (34.2 %) were sexually active. Adolescents on ART were twice likely to present with better physical health and four times more likely to present with better mental health than those who were not on ART. There were no statistically significant associations between SRH (ever had sex, ever been pregnant, condom use, contraceptive use) or life style factors and physical health or mental health. Those with secondary or tertiary education were more likely to present with a better mental health compared those who had attained primary or no education. Participants who desired to have a child in future more likely to present with a better mental health. Lack of communication with guardians on sexuality, or dissatisfaction with SRH services were associated with poorer mental health.

Among perinatally HIV-infected adolescents in Uganda, being on ART was associated with better physical and mental health while lack of communication with guardians on sexuality or dissatisfaction with SRH services was associated with poor mental health. Adolescents with pregnancy intentions were more likely to have a better mental health.

Table 1

Descriptive statistics on the sample of HIV perinatally infected adolescents (n = 614)

Variables		Frequency	Percentage
Sex	Male	253	41.2
	Female	361	58.8
Age groups	10 – 14 years	114	18.6
	15 – 19 years	500	81.4
Religion	Catholic	257	41.9
	Protestant	247	40.2
	Others	110	17.9
Education status	Out of school	159	25.9
	In school	455	74.1
Highest Level of education attained	None	29	4.7
	Primary level	355	57.2
	Secondary level	230	37.5
Highest level of education hoped to complete	Primary	63	10.3
	Secondary	106	17.3
	Tertiary	374	60.9
	Don’t know	71	11.6
Occupation	Students	455	74.1
	Volunteers	49	8
	Stays home	110	17.9
Region	Western	229	37.3
	Eastern	172	28
	Northern	213	34.7
Distance to clinic	Within 5 km	193	31.4
	More than 5 km	421	68.6
Living with parents	Both parents	103	16.8
	One parent	243	39.4
	Not staying with any parents	268	43.6

Below:  Distribution of physical and mental scores after Principal Component Analysis

Below:  Median scores for PHS and MHS of the sample of HIV perinatally infected adolescents (n = 614)

Full article at: http://goo.gl/8032mr

By: Mbalinda SN1, Kiwanuka N2, Kaye DK3, Eriksson LE4,5,6.

• 1Department of Nursing, School of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Uganda. snmbalinda@gmail.com.
• 2Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. nkiwanuka@gmail.com.
• 3Department of Obstetrics and Gynecology, College of Health Sciences, Makerere University, Kampala, Uganda. dankkaye@yahoo.com.
• 4Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden. Lars.Eriksson@ki.se.
• 5Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. Lars.Eriksson@ki.se.
• 6School of Health Sciences, City University London, London, UK. Lars.Eriksson@ki.se.  

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