Top

Published in:

Open Access 01-12-2023 | Human Immunodeficiency Virus | Research

Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study

Authors: 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

Published in: BMC Psychiatry | Issue 1/2023

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.

Panos G, Samonis G, Alexiou VG, Kavarnou GA, Charatsis G, Falagas ME. Mortality and morbidity of HIV infected patients receiving HAART: a cohort study. Curr HIV Res. 2008;6(3):257–60. https://doi.org/10.2174/157016208784324976CrossRefPubMed

Schwartländer B, Grubb I, Perriëns J. The 10-year struggle to provide antiretroviral treatment to people with HIV in the developing world. The Lancet. 2006 Aug;5(9534):541–6.

Ford N, Calmy A, Mills EJ. The first decade of antiretroviral therapy in Africa. Globalization and health. 2011 Dec;7(1):33.

Kim J, Lee E, Park BJ, Bang JH, Lee JY. Adherence to antiretroviral therapy and factors affecting low medication adherence among incident HIV-infected individuals during 2009–2016: A nationwide study.Sci Rep. 2018 Feb16;8(1):3133. https://doi.org/10.1038/s41598-018-21081-x. PMID: 29453393; PMCID: PMC5816616.

Sabin CA, Lundgren JD. The natural history of HIV infection. Curr Opin HIV and. 2013;8(4):311–7. https://doi.org/10.1097/COH.0b013e328361fa66CrossRef

Eisinger RW, Dieffenbach CW, Fauci AS. HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable. JAMA. 2019;321(5):451–2.CrossRefPubMed

Joint United Nations Programme on HIV/AIDS (UNAIDS). AIDS by the numbers. Jc2571/1/E., 2015. Retrieved from http://search.unaids.org

Bezabhe WM, Chalmers L, Bereznicki LR, Peterson GM, Bimirew MA, Kassie DM. Barriers and facilitators of adherence to antiretroviral drug therapy and retention in care among adult HIV-positive patients: a qualitative study from Ethiopia. PLoS ONE. 2014;9(5). https://doi.org/10.1371/journal.pone.0097353

Bukenya D, Mayanja BN, Nakamanya S, Muhumuza R, Seeley J. What causes non-adherence among some individuals on long term antiretroviral therapy? Experiences of individuals with poor viral suppression in Uganda. AIDS Res Ther. 2019 Jan 21;16(1):2. https://doi.org/10.1186/s12981-018-0214-y. PMID: 30665440; PMCID: PMC6340167.

10.

AIDS Patient Care and STDs, 33(9), 406–413. https://doi.org/10.1089/apc.2019.0053

11.

Suleiman IA, Momo A. Adherence to antiretroviral therapy and its determinants among persons living with HIV/AIDS in Bayelsa state, Nigeria. Pharm Pract (Granada). 2016 Jan-Mar;14(1):631. doi: 10.18549/PharmPract.2016.01.631. Epub 2016 Mar 15. PMID: 27011771; PMCID: PMC4800010.

12.

Croome N, Ahluwalia M, Hughes LD, Abas M. Patient-reported barriers and facilitators to antiretroviral adherence in sub-saharan Africa. AIDS. 2017;31(7):995–1007. https://doi.org/10.1097/QAD.0000000000001416CrossRefPubMed

13.

Anyaike C, Atoyebi OA, Musa OI, Bolarinwa OA, Durowade KA, Ogundiran A, Babatunde OA. Adherence to combined Antiretroviral therapy (cART) among people living with HIV/AIDS in a Tertiary Hospital in Ilorin, Nigeria.Pan Afr Med J. 2019 Jan7;32:10. https://doi.org/10.11604/pamj.2019.32.10.7508. PMID: 31080546; PMCID: PMC6497984.

14.

Genberg BL, Lee Y, Rogers WH, Wilson IB. Four types of barriers to adherence of antiretroviral therapy are associated with decreased adherence over time. AIDS Behav. 2015 Jan;19(1):85–92. https://doi.org/10.1007/s10461-014-0775-2. PMID: 24748240; PMCID: PMC4203705.

15.

Umeokonkwo CD, Onoka CA, Agu PA, Ossai EN, Balogun MS, Ogbonnaya LU. Retention in care and adherence to HIV and AIDS treatment in Anambra State Nigeria. BMC Infect Dis. 2019 Jul 22;19(1):654. https://doi.org/10.1186/s12879-019-4293-8. PMID: 31331280; PMCID: PMC6647106.

16.

Dawson-Rose C, Gutin SA, Cummings B, Jaiantilal P, Johnson K, Mbofana F. ART Adherence as a Key Component of Prevention With Persons Living With HIV in Mozambique.J Assoc Nurses AIDS Care. 2016 Jan-Feb;27(1):44–56. https://doi.org/10.1016/j.jana.2015.10.001. Epub 2015 Oct 13. PMID: 26552865; PMCID: PMC6097618.

17.

Green A. HIV in Mozambique: starting, and staying on, treatment. Lancet. 2016 Jan 30;387(10017):420-1. https://doi.org/10.1016/S0140-6736(16)00213-0. PMID: 26869557.

18.

Groh K, Audet CM, Baptista A, Sidat M, Vergara A, Vermund SH, Moon TD. Barriers to antiretroviral therapy adherence in rural Mozambique. BMC Public Health. 2011;11(1):650. https://doi.org/10.1186/1471-2458-11-650CrossRefPubMedPubMedCentral

19.

Parcesepe, A. M., Filiatreau, L. M., Ebasone, P. V., Dzudie, A., Pence, B. W., Wainberg,M., … Nash, D. (2021). Mental health and initiation of antiretroviral treatment at enrolment into HIV care in Cameroon under a national “ treat all ” policy: a cross-sectional analysis. Journal of the International AIDS Society 2021, 24, 1–6. https://doi.org/10.1002/jia2.25842

20.

Nakimuli-Mpungu E, Bass JK, Alexandre P, Mills EJ, Musisi S, Ram M, Katabira E, Nachega JB. Depression, alcohol use and adherence to antiretroviral therapy in sub-Saharan Africa: a systematic review. AIDS Behav. 2012 Nov;16(8):2101-18. https://doi.org/10.1007/s10461-011-0087-8. PMID: 22116638.

21.

Collins PY, Holman AR, Freeman MC, Patel V. What is the relevance of mental health to HIV/AIDS care and treatment programs in developing countries? A systematic review. AIDS. 2006;20(12):1571–82.CrossRefPubMed

22.

Nel A, Kagee A. Common mental health problems and antiretroviral therapy adherence. AIDS Care. 2011 Nov;23(11):1360–5.

23.

Wykowski J, Kemp CG, Velloza J, Rao D, Drain PK. Associations between anxiety and adherence to antiretroviral Medications in Low and Middle Income Countries: a systematic review and Meta analysis. AIDS Behav. 2019;23(8):2059–71. https://doi.org/10.1007/s10461-018-02390-8CrossRefPubMedPubMedCentral

24.

Magidson JF, Saal W, Nel A, Remmert JE, Kagee A. Relationship between depressive symptoms, alcohol use, and antiretroviral therapy adherence among HIV-infected, clinic-attending patients in South Africa. J Health Psychol. 2017;22(11):1426–33. https://doi.org/10.1177/1359105316628743CrossRefPubMed

25.

Haas, A. D., Ruffieux, Y., van den Heuvel, L. L., Lund, C., Boulle, A., Euvrard, J.,… Wainberg, M. L. (2020). Excess mortality associated with mental illness in people living with HIV in Cape Town, South Africa: a cohort study using linked electronic health records. The Lancet Global Health, 8(10), e1326–e1334. https://doi.org/10.1016/S2214-109X(20)30279-5

26.

Ngum PA, Fon PN, Ngu RC, Verla VS, Luma HN. Depression among HIV / AIDS patients on highly active antiretroviral therapy in the Southwest Regional Hospitals of Cameroon: a cross-sectional study. Neurol Therapy. 2017;6(1):103–14. https://doi.org/10.1007/s40120-017-0065-9CrossRef

27.

Sajatovic M, Levin J, Fuentes-Casiano E, Cassidy KA, Tatsuoka C, Jenkins JH. Illness experience and reasons for nonadherence among individuals with bipolar disorder who are poorly adherent with medication. Compr Psychiatry. 2011 May-Jun;52(3):280–7. Epub 2010 Sep 1. PMID: 21497222; PMCID: PMC3140848.

28.

Mellins CA, Havens JF, McDonnell C, Lichtenstein C, Uldall K, Chesney M, Santamaria EK, Bell J. Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders. AIDS Care. 2009 Feb;21(2):168–77. PMID: 19229685; PMCID: PMC5584780.

29.

Karcher H, Omondi A, Odera J, Kunz A, Harms G. Risk factors for treatment denial and loss to follow-up in an antiretroviral treatment cohort in Kenya. Trop Med Int Health. 2007;12(5):687–94. https://doi.org/10.1111/j.1365-3156.2007.01830.xCrossRefPubMed

30.

Olowookere SA, Fatiregun AA, Akinyemi JO, Bamgboye AE, Osagbemi GK. Prevalence and determinants of nonadherence to highly active antiretroviral therapy among people living with HIV / AIDS in Ibadan, Nigeria. J Infect Developing Countries. 2008;2(5):369–72.

31.

Anyaike C, Atoyebi OA, Musa OI, Bolarinwa OA, Durowade KA, Ogundiran A, Babatunde OA. Adherence to combined antiretroviral therapy (cART) among people living with HIV/AIDS in a Tertiary Hospital in Ilorin, Nigeria. Pan Afr Med J. 2019;32(10):1–12. https://doi.org/10.11604/pamj.2019.32.10.7508CrossRef

32.

Haas AD, Ruffieux Y, van den Heuvel LL, Lund C, Boulle A, Euvrard J, Orrell C, Prozesky HW, Tiffin N, Lovero KL, Tlali M, Davies MA, Wainberg ML. ; IeDEA Southern Africa collaboration. Excess mortality associated with mental illness in people living with HIV in Cape Town, South Africa: a cohort study using linked electronic health records.Lancet Glob Health. 2020 Oct;8(10):e1326-e1334. https://doi.org/10.1016/S2214-109X(20)30279-5. PMID: 32971055; PMCID: PMC7582785.

33.

Chibanda D, Cowan F, Gibson L, Weiss HA, Lund C. Prevalence and correlates of probable common mental disorders in a population with high prevalence of HIV in Zimbabwe.BMC Psychiatry. 2016 Feb29;16:55. https://doi.org/10.1186/s12888-016-0764-2. PMID: 26926690; PMCID: PMC4772683.

34.

Nouaman MN, Vinikoor M, Seydi M, Ekouevi DK, Coffie PA, Mulenga L, Tanon A, Egger M, Dabis F, Jaquet A, Wandeler G, IeDEA. High prevalence of binge drinking among people living with HIV in four african countries. J Int AIDS Soc. 2018 Dec;21(12):e25202. https://doi.org/10.1002/jia2.25202. PMID: 30549445; PMCID: PMC6294116.

35.

Klis S, Velding K, Gidron Y, Peterson K. Posttraumatic stress and depressive symptoms among people living with HIV in the Gambia. AIDS Care. 2011;23(4):426–35. https://doi.org/10.1080/09540121.2010.507756CrossRefPubMed

36.

Marwick KFM, Kaaya SF. Prevalence of depression and anxiety disorders in HIV- positive outpatients in rural Tanzania. AIDS Care. 2010;22(4):415–9. https://doi.org/10.1080/09540120903253981CrossRefPubMed

37.

Ogundipe OA, Olagunju AT, Adeyemi JD. Suicidal ideation among attendees of a West African HIV clinic. Arch Suicide Res. 2015;19(1):103 – 16. doi: 10.1080/13811118.2014.915776. PMID: 25058473.

38.

Olagunju AT, Adeyemi JD, Ogundipe OA, Erinfolami AR. Factors associated with anxiety disorders among HIV-positive attendees of an HIV clinic in Lagos, Nigeria. Int J STD AIDS. 2012;23:389–93.CrossRefPubMed

39.

Breuer E, Myer L, Struthers H, Joska JA. HIV/AIDS and mental health research in sub-Saharan Africa: a systematic review. Afr J AIDS Res. 2011 Jun;10(2):101 – 22. https://doi.org/10.2989/16085906.2011.593373. PMID: 25859733.

40.

Rudy BJ, Murphy DA, Harris DR, Muenz L, Ellen J. Patient-related risks for nonadherence to antiretroviral therapy among HIV-Infected Youth in the United States: a study of prevalence and interactions. Volume 23. AIDS PATIENT CARE and STDs; 2009. pp. 185–94. 3.

41.

Applebaum AJ, Richardson MA, Brady SM, Brief DJ, Keane TM. Gender and other psychosocial factors as predictors of adherence to highly active antiretroviral therapy (HAART) in adults with comorbid HIV/AIDS, psychiatric and substance-related disorder. AIDS Behav. 2009 Feb;13(1):60–5. Epub 2008 Aug 9. PMID: 18690532.

42.

López JD, Shacham E, Brown T. Suicidal ideation persists among individuals engaged in HIV Care in the era of antiretroviral therapy. AIDS Behav. 2018;22:800–5. https://doi.org/10.1007/s10461-016-1666-5CrossRefPubMed

43.

Wykowski J, Kemp CG, Velloza J, Rao D, Drain PK. Associations between anxiety and adherence to antiretroviral medications in low- and Middle-Income Countries: a systematic review and Meta-analysis. AIDS Behav. 2019;23(8):2059–71. https://doi.org/10.1007/s10461-018-02390-8CrossRefPubMedPubMedCentral

44.

Badiee J, Riggs PK, Rooney AS, Vaida F, Grant I, Atkinson JH, Moore DJ. Approaches to identifying appropriate medication adherence assessments for HIV infected individuals with comorbid bipolar disorder. AIDS Patient Care STDs. 2012;26(7):388–94. https://doi.org/10.1089/apc.2011.0447CrossRefPubMedPubMedCentral

45.

Levin JB, Aebi ME, Howland M, Barboza M, Eskew L, Tatsuoka C, Cassidy KA, Sajatovic M. The relationship between medication attitudes and medication adherence behavior in adults with bipolar disorder. J Nerv Ment Dis. 2020 Feb;208(2):87–93. PMID: 31929465; PMCID: PMC7316161.

46.

Wagner GJ, Kanouse DE, Koegel P, Sullivan G. Adherence to HIV antiretrovirals among persons with serious mental illness. AIDS Patient Care STDs. 2003;17(4):179–86. https://doi.org/10.1089/108729103321619782CrossRefPubMed

47.

Adrawa N, Alege JB, Izudi J. Alcohol consumption increases nonadherence to ART among people living with HIV enrolled to the community-based care model in rural northern Uganda. PLoS ONE. 2020;15(11 November):1–12. https://doi.org/10.1371/journal.pone.0242801CrossRef

48.

EClinicalMedicine, 31, 100621. https://doi.org/10.1016/j.eclinm.2020.100621

49.

Caniglia EC, Khan M, Ban K, Braithwaite RS. Integrating screening and treatment of unhealthy Alcohol Use and Depression with Screening and treatment of anxiety, Pain, and other Substance Use among People with HIV and other high-risk persons. AIDS Behav. 2021;25(s3):339–46. https://doi.org/10.1007/s10461-021-03245-5CrossRefPubMedPubMedCentral

50.

Uthman OA, Magidson JF, Safren SA, Nachega JB. Depression and adherence to antiretroviral therapy in low-, middle- and high-income countries: a systematic review and meta-analysis. Curr HIV/AIDS. 2014;11(3):291–307. https://doi.org/10.1007/s11904-014-0220-1CrossRef

51.

Ministério da Saúde- MISAU., Instituto Nacional de Estatística - INE, and ICF. Inquérito de Indicadores de Imunização, Malária e HIV/SIDA em Moçambique (IMASIDA) 2015. Maputo/Moçambique: MISAU/Moçambique, INE, and ICF2018. Available at http://dhsprogram.com/pubs/pdf/AIS12/AIS12.pdf

52.

UNAIDS, Global. HIV & AIDS statistics – 2018 fact sheet. http://www.unaids.org/en/resources/fact-sheethttps://www.unaids.org/en/regionscountries/countries/mozambique

53.

Lafort Y, Couto A, Sunderbrink U, Hoek R, Shargie E, Zhao J, Viisainen K, Simwaka B. Validity of reported retention in antiretroviral therapy after roll-out to peripheral facilities in Mozambique: Results of a retrospective national cohort analysis. PLoS One. 2018 Jun 21;13(6):e0198916. https://doi.org/10.1371/journal.pone.0198916. PMID: 29927961; PMCID: PMC6013210.

54.

Palladino C, Briz V, Bellón JM, Bártolo I, Carvalho P, Camacho R, Muñoz-Fernández M, Bastos R, Manuel R, Casanovas J, Taveira N. Predictors of attrition and immunological failure in HIV-1 patients on highly active antiretroviral therapy from different healthcare settings in Mozambique.PLoS One. 2013 Dec20;8(12):e82718. https://doi.org/10.1371/journal.pone.0082718. PMID: 24376569; PMCID: PMC3869714.

55.

Veld DHI’, Pengpid S, Colebunders R, Skaal L, Peltzer K. High-risk alcohol use and associated socio-demographic, health and psychosocial factors in patients with HIV infection in three primary health care clinics in South Africa. Int J STD AIDS. 2017 Jun;28(7):651–9. Epub 2016 Jul 21. PMID: 27448655.

56.

Nakasujja N, Skolasky RL, Musisi S, Allebeck P, Robertson K, Ronald A, Katabira E, Clifford DB, Sacktor N. Depression symptoms and cognitive function among individuals with advanced HIV infection initiating HAART in Uganda. BMC Psychiatry. 2010 Jun10;10:44. https://doi.org/10.1186/1471-244X-10-44. PMID: 20537129; PMCID: PMC2901316.

57.

Ministério da Saúde (MISAU). Direcção Nacional de Assistência Médica (DNAM), Guião de actividades de apoio psicossocial e Prevenção Positiva. APSS & PP); 2015.

58.

Lovero KLBC, Khan S, Suleman A, Mabunda D, Feliciano P, dos Santos P, Fumo W, Greene MC, Fiks Salem A, Mootz JJ, Mocumbi MO, Duarte CS, Gouveia L, Oquendo MA, Wall MM, Wainberg ML. Brief Screening Tool for Stepped-Care Management of Mental and Substance Use Disorders. Psych services 2020. Under Review

59.

WHO. Process of translation and adaptation of instruments. https://www.who.int/substance_abuse/research_tools/translation/en/

60.

Amorim P, Mini International Neuropsychiatric Interview (MINI). Validação de entrevista breve para diagnóstico de transtornos mentais. Braz J Psychiatry. 2000;22(3):106–15.CrossRef

61.

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33. quiz 34–57. PMID: 9881538.PubMed

62.

Wilson IB, Lee Y, Michaud J, Fowler FJ Jr, Rogers WH. Validation of a New Three-Item Self-Report measure for Medication Adherence. AIDS Behav. 2016 Nov;20(11):2700–8. PMID: 27098408; PMCID: PMC5071118.

63.

Gaynes BN, Pence BW, Eron JJ, Miller WC. Prevalence and comorbidity of psychiatric diagnoses based on reference standard in an HIV + patient population. Psychosom Med. 2008;70(4):505–11. https://doi.org/10.1097/PSY.0b013e31816aa0ccCrossRefPubMedPubMedCentral

64.

Gill A, Ranasinghe AWIP, Sumathipala A, Fernando KA. Prevalence of mental health conditions amongst people living with human immunodeficiency virus in one of the most deprived localities in England. Int J STD AIDS. 2020;31(7):619–26. https://doi.org/10.1177/0956462420904299CrossRefPubMed

65.

Filimão DBC, Moon TD, Senise JF, Diaz RS, Sidat M, Castelo A. Individual factors associated with time to non-adherence to ART pick-up within HIV care and treatment services in three health facilities of Zambézia Province, Mozambique.PLoS One. 2019 Mar25;14(3):e0213804. https://doi.org/10.1371/journal.pone.0213804. PMID: 30908522; PMCID: PMC6433271.

66.

Charurat M, Oyegunle M, Benjamin R, Habib A, Eze E, Ele P, Ibanga I, Ajayi S, Eng M, Mondal P, Gebi U, Iwu E, Etiebet MA, Abimiku A, Dakum P, Farley J, Blattner W. Patient retention and adherence to antiretrovirals in a large antiretroviral therapy program in Nigeria: a longitudinal analysis for risk factors. PLoS One. 2010 May 11;5(5):e10584. https://doi.org/10.1371/journal.pone.0010584. PMID: 20485670; PMCID: PMC2868044.

67.

Mukui IN, Ng’ang’a L, Williamson J, Wamicwe JN, Vakil S, Katana A, Kim AA. Rates and Predictors of Non-Adherence to Antiretroviral Therapy among HIV-Positive Individuals in Kenya: Results from the Second Kenya AIDS Indicator Survey, 2012. PLoS One. 2016 Dec 1;11(12):e0167465. https://doi.org/10.1371/journal.pone.0167465. PMID: 27907114; PMCID: PMC5131960.

68.

Nachega JB, Mutamba B, Basangwa D, Nguyen H, Dowdy DW, Mills EJ, Katabira E, Nakimuli-Mpungu E. Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected ugandan adults. Trop Med Int Health. 2013 Jan;18(1):53–7. https://doi.org/10.1111/tmi.12019. Epub 2012 Nov 8. PMID: 23136882.

69.

Sajatovic M, Levina J, Fuentes-Casianoa E, Cassidy KA, Tatsuoka C, Jenkins JH. Illness experience and reasons for nonadherence among individuals with bipolar disorder who are poorly adherent with medication. Compr Psychiatry. 2011;52(3):280–7. https://doi.org/10.1016/j.comppsych.2010.07.002CrossRefPubMed

70.

Bogart LM, Fremont AM, Young AS, Pantoja P, Chinman M, Morton S, Koegel P, Sullivan G, Kanouse DE. Patterns of HIV care for patients with serious mental illness. AIDS Patient Care STDS. 2006 Mar;20(3):175–82. https://doi.org/10.1089/apc.2006.20.175. PMID: 16548714.).

71.

Velloza J, Kemp CG, Aunon FM, Ramaiya MK, Creegan E, Simoni JM. Alcohol use and antiretroviral therapy non-adherence among adults living with HIV/AIDS in Sub-Saharan Africa: a systematic review and Meta-analysis. AIDS Behav. 2020 Jun;24(6):1727–42. https://doi.org/10.1007/s10461-019-02716-0. PMID: 31673913; PMCID: PMC7190427.

72.

Chibanda D, Benjamin L, Weiss HA, Abas M. Mental, neurological, and Substance Use Disorders in people living with HIV/AIDS in Low- and Middle-Income Countries. J Acquir Immune Defic Syndr. 2014;67(1):54–S67.CrossRef

73.

Campos LN, Guimarães MDC, Remien RH. Anxiety and depression symptoms as risk factors for non-adherence to antiretroviral therapy in Brazil. AIDS Behav. 2010;14(2):289–99. https://doi.org/10.1007/s10461-008-9435-8CrossRefPubMed

74.

Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7. https://doi.org/10.1097/QAI.0B013E31822D490ACrossRefPubMed

75.

Been SK, Schadé A, Bassant N, Kastelijns M, Pogány K, Verbon A. Anxiety, depression and treatment adherence among HIV-infected migrants. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2019;31(8):979–87. https://doi.org/10.1080/09540121.2019.1601676CrossRef

76.

77.

Int J STD AIDS, 27(11), 938–949. https://doi.org/10.1177/0956462415600582.Psychiatric

78.

Marinda E, Zungu N, Chikovore J, Mthembu J, Magampa M, Mathentamo Q, Nwosu CO, Maoba P, Ramlagan S, Zuma K, Moyo S, Simbayi L. Association between ART Adherence and Mental Health: results from a National HIV sero-behavioural survey in South Africa. AIDS Behav. 2022 May;26(5):1517–29. https://doi.org/10.1007/s10461-021-03505-4. Epub 2021 Oct 23. PMID: 34686946.

79.

Springer SA, Dushaj A, Azar MM. The impact of DSM-IV Mental Disorders on Adherence to Combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review. AIDS Behav. 2012;16:2119–43. https://doi.org/10.1007/s10461-012-0212-3CrossRefPubMedPubMedCentral

80.

Smith R, Villanueva G, Probyn K, Sguassero Y, Ford N, Orrell C, Cohen K, Chaplin M, Leeflang MM, Hine P. Accuracy of measures for antiretroviral adherence in people living with HIV.Cochrane Database Syst Rev. 2022 Jul25;7(7):CD013080. https://doi.org/10.1002/14651858.CD013080.pub2. PMID: 35871531; PMCID: PMC9309033.

81.

Wainberg ML, Gouveia ML, Stockton MA, Feliciano P, Suleman A, Mootz JJ, Mello M, Fiks Salem A, Greene MC, Bezuidenhout C, Ngwepe P, Lovero KL, Fortunato Dos Santos P, Schriger SH, Mandell DS, Mulumba R, Neves Anube A, Mabunda D, Mandlate F, Cournos F, Alves-Bradford JM, Nicholson T, Kann B, Fumo W, Duarte CS, de Jesus Mari J, Mello MF, Mocumbi AO, Oquendo MA, Weissman MM. Technology and implementation science to forge the future of evidence-based psychotherapies: the PRIDE scale-up study. Evid Based Ment Health. 2021 Feb;24(1):19–24. https://doi.org/10.1136/ebmental-2020-300199. Epub 2020 Nov 11. PMID: 33177149; PMCID: PMC8

Title: Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study
Authors: 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
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Human Immunodeficiency Virus
Acquired Immune Deficiency Syndrome
Published in: BMC Psychiatry / Issue 1/2023
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-023-04782-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

Neurobiological mechanisms of ECT and TMS treatment in depression: study protocol of a multimodal magnetic resonance investigation

First episode psychosis and beyond: much progress made but much more needed

The effect of intolerance of uncertainty on anxiety and depression, and their symptom networks, during the COVID-19 pandemic

Altered prefrontal beta oscillatory activity during removal of information from working memory in obsessive-compulsive disorder

Study protocol: combined N-of-1 trials to assess open-label placebo treatment for antidepressant discontinuation symptoms [FAB-study]

Harsh parenting and suicide ideation among Chinese adolescents: the roles of self-esteem and school social support