Abstract
Purpose
Adolescents living with HIV (ALHIV) are at high risk for adherence to antiretroviral (ART) treatment and poor health-seeking behaviors, both of which potentially compromise their quality of and satisfaction with life. This study, therefore, seeks to examine the relationship between physical health, pediatric quality of life, life satisfaction, and medication adherence among ALHIV in southwestern Uganda.
Methods
Baseline data from the Suubi+Adherence study, 2012–2018, that recruited 702 adolescents, aged 10–16 years, living with HIV in Uganda were analyzed. To account for overdispersion, negative binomial regression analyses were used to examine the impact of physical health, pediatric quality of life, and life satisfaction on self-reported medication adherence. We controlled for participants’ socio-demographic factors.
Results
Results indicated that after adjusting for socio-demographic characteristics, adolescents’ reported satisfaction with life was associated with a decrease in the reported number of days missed taking medication by 41.2% (IRR (incidence risk ratio) = 0.588; p (p value) = 0.014). On the other hand, the low level of pediatric quality of life was associated with a 5% increase in the reported number of days missed taking medication (IRR = 1.055, p = 0.044). Personal health was not statistically significant in the model.
Conclusion
Our study findings indicated that quality of life and life satisfaction are significantly associated with antiretroviral (ART) medication among ALHIV. Hence, strengthening existing support systems and creating additional support for optimal ART adherence and treatment outcomes for ALHIV in low-resource communities might be beneficial. Moreover, with the increasing HIV prevalence rates among adolescents, effective and comprehensive efforts that are responsive to the special needs of ALHIV must be developed to ensure optimal adherence to ART medication as it leads to low vertical infection and superinfection rates.
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Acknowledgments
We are grateful to our field collaborators, including Rakai Health Sciences Program in Uganda, Reach the Youth—Uganda, and the staff at the International Center for Child Health and Development (ICHAD) for their respective contributions to the study design, implementation, and data management. We wish to thank all of the participants and their families who have given their time for this study.
Funding
This work was supported by The National Institute of Child Health and Human Development (Grant No. R01HD074949) and the National Institute of Mental Health Research Resiliency Training Program (Grant No. R25MH118935). The views expressed in this paper are solely the responsibility of the authors and do not represent the views of the National Institutes of Health.
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WB led the data analysis, and drafted and edited the manuscript. PN, JM, LZ, RB, and OSB drafted and edited the manuscript, while CD, FN, and JN supervised study implementation in the field. TBN was the statistical consultant for the study, AM, BM, and CM were co-investigators, and FMS conceptualized and received funding for the study as well as leading and supervising all aspects of study implementation. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was received from Columbia University Institutional Review Board #AAAK3852, Makerere University School of Public Health Ethics Committee Protocol # 210 and Uganda National Council of Science and Technology SS 2969.
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Informed consent was obtained from all individual participants included in the study.
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Byansi, W., Nabunya, P., Muwanga, J. et al. The relationship between life satisfaction, personal health, quality of life, and medication adherence among adolescents living with HIV in southwestern Uganda. J Public Health (Berl.) 31, 1177–1184 (2023). https://doi.org/10.1007/s10389-021-01632-9
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DOI: https://doi.org/10.1007/s10389-021-01632-9