Prevalence of Depression, Alcohol Use Disorder and Their Association With Anti-retroviral Therapy Adherence Among Adult Patients Attending Comprehensive Care Centre Busia County Referral Hospital

Abstract

Background: People Living with HIV & AIDS (PLWHIVA) face several mental health problems. Unfortunately, there ispaucity of epidemiological data that have assessed the prevalence of mental health problems among these populations living in Sub-Saharan Africa (SSA) where the largest numbers are of individuals on Anti-Retroviral Therapy (ART). Further, there is great vulnerability among PLWHIV/AIDS to Depressive Disorders (DD) and Alcohol Use Disorder (AUD) leading to poor adherence to ART. To determine the prevalence of Depression, Alcohol Use Disorder and their association with ART adherence among adult PLWHIVA attending Comprehensive Care Centre, Busia Referral County Hospital (BCRH). Methods: Descriptive cross-sectional study was carried out on 344 respondents. Alcohol Use Disorders Identification Tool (AUDIT), Becks Depression Inventory scale (BDI), research-developed socio-demographic questionnaire and CASE Adherence Index Questionnaires were approved by KNH-UoN-ERC and used. Statistical Package for Social Sciences version 23 was applied using descriptive statistics and logistic regression analysis to determine the associations between AUD, Depression, ART adherence and socio-demographic variables set at p-value <0.05. Results were presented in figures, tables, pie-charts and narratives. Results: The prevalence rate of depression was 13.7%, AUD 5.8 % and Adherence to ART 83.1%. While there was no statistically significant association between depression and adherence to ART (OR=1.871, 95% CI 0.904-3.871, p =0.091), the likelihood of having AUD when one had poor adherence was higher (OR=2.882, 95% CI 1.097-7.575, p =0.032), odds of developing depression when one had no AUD was lower (OR=0.338, 95% CI 0.123-0.929, p =0.03). After adjusting for each significant predictor, being male showed lower likelihood to having depression and AUD (AOR=0.249, 95% CI 0.101-0.61, p=0.002) (AOR=0.249, 95% CI 0.101-0.611, p=0.050) respectively while showing higher likelihood to depression on being on ART for less than a year (AOR=5.859, 95% CI 1.466-23.420 p=0.012) and being on ART for more than two years but less than 5 years(AOR=2.722, 95% CI 1.112-6.660, p=0.028). Additionally, higher likelihood to AUD was seen in being on ART for more than a year but less than 2 years (AOR=19.674, 95% CI 1.199-322.766, p=0.037). In adherence to ART, higher likelihood was seen in being in first line regimen (AOR=2.692, 95% CI 1.264-5.736 p=0.010) Conclusion: Being female and being on ART treatment within first 5 years has shown to increase odds of developing these psychological distresses among the respondents. On HIV/AIDS, being on 1st line regimen affects one’s adherence to ART. No statistically significant relationship was observed between depression and adherence to ART however, there was significant relationship between; AUD and depression, AUD and poor adherence.