Background
Through
access to life saving antiretroviral treatment (ART) in southern Africa, HIV
has been reconceptualised as a chronic disease. This comes with new challenges
of HIV-related co-morbidities and disabilities. We still lack an understanding
of the types and scope of disabilities experienced by people on long term ART
and how this impacts health, adherence, and livelihood. This paper describes
the results of a cohort study examining the new health- and disability-related
needs of the millions of people on ART in the region.
Methods
Data
was collected from a cohort of people who had been on ART for six months or
longer in a semi-urban public health care setting in South Africa. 1042 adults
(18 and older) participated in the cross-sectional study which investigated
disabilities/activity limitations, health, ART adherence, depression symptoms,
and livelihood. We analysed the associations between these constructs using
descriptive statistics, and bivariate and multivariate analyses.
Results
A
large number of participants (35.5%) obtained a weighted score of two or more
on the WHODAS 2.0 indicating possible activity limitations. A positive
relationship was found between activity limitations and depression symptoms,
adherence, and worse health outcomes, while none was found for BMI or CD4
count. These associations varied by type of activity limitations and, in some
cases, by gender.
Conclusion
Activity limitations are potentially experienced by a
large portion of people on ART in southern Africa which impacts health and ART
adherence negatively. These results highlight the importance of better
understanding the new health-related needs of people who are on long term ART,
as well as the nuances of the disability they experience. This is urgently
needed in order to enable HIV-endemic countries to better prepare for the new
health-related needs of the millions of people on ART in southern Africa.
Below: Percentage of Participants experiencing one or more activity limitations
Below: Boxplot of converted health scores in percentages split by disability status
Full article at: http://goo.gl/m2TzIs
By:
Jill Hanass-Hancock, Bradley Carpenter
Health Economics and HIV and AIDS Research Division (HEARD),
University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
Hellen Myezwa
Department of Physiotherapy, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, Gauteng, South Africa
More at: https://twitter.com/hiv_insight
No comments:
Post a Comment