Psychiatric Disorders & Adherence to Antiretroviral Therapy among a Population of HIV-Infected Adults in Nigeria

Psychiatric disorders are common among persons with HIV in Nigeria. Adherence is necessary to optimise the outcome of antiretroviral therapy. In this study, we aimed to identify associations between antiretroviral adherence measured by one-week and one-month self-reported missed doses, and psychiatric illness in a cohort previously assessed for psychiatric disorders using the Composite International Diagnostic Interview. 

The study participants comprised 151 adults with major depression, anxiety or suicidal symptoms, and 302 matched-control participants. Two controls were randomly selected for each case within the same gender and education stratum. We compared participants with psychiatric disorders (WPDs) and no psychiatric disorders (NPDs) on selected demographic and clinical variables, in addition to adherence. 

Participants with one or more missed doses in the preceding month had twice the odds of having a major depressive episode as those with no missed doses during this period. This association remained significant after adjusting for selected risk factors. There was no statistically significant difference between WPD and NPD groups on either one-week or one-month adherence, or on age, marital status, occupational class, HIV viral load at enrolment or current CD4. 

Among Nigerian adults with HIV, suboptimal antiretroviral adherence is associated with, and could be a signal of depression. Routine self-report adherence assessments may have potential utility for identifying individuals at risk among this population.

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By: Adejumo O1, Oladeji B2, Akpa O3, Malee K4, Baiyewu O2, Ogunniyi A5, Evans S6, Berzins B7, Taiwo B8.

• 1Department of Psychiatry, University of Ibadan, Nigeria
• 2Department of Psychiatry, University of Ibadan, Nigeria.
• 3Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria.
• 4Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
• 5Department of Medicine, University of Ibadan, Nigeria.
• 6Harvard School of Public Health, Boston, MA, USA.
• 7Center for Global Health, Northwestern University, USA.
• 8Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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