Association between common mental disorders and adherence to HIV care among women attending a HIV clinic in burnt forest, Kenya

Abstract

Background: Mental health disorders have been shown to pose a significant health burden in HIV infected women and are associated with non-adherence to care. It is therefore imperative to diagnose and manage them early to ensure optimal health outcomes. Objectives: This study assessed the prevalence of depression, anxiety and alcohol use disorder and evaluated their association with adherence to clinic appointment and to antiretroviral treatment in women attending a HIV clinic in Burnt Forest, Kenya. Methods: Interviews were conducted with 250 women on ART attending the Burnt Forest HIV clinic over a one-month period. Socio-demographic and adherence information was collected and; PHQ-9, GAD-7 and AUDIT were used to screen for symptoms of depression, anxiety and alcohol use disorder respectively. Descriptive statistics was used to summarize the data and multivariate logistic regression used to model the association between the socio-demographic factors, mental disorders and adherence. Results: The mean age for the respondents was 39.3 years (SD ±9.3 years) with nearly half (49.2%) reporting having ever missed a clinic appointment. The prevalence of depression, anxiety and alcohol use disorder was 24%, 16% and 4% respectively; and the overall adherence to ART was 89%. There was no association between the assessed mental disorders and any of the adherence measures. Conclusion: There is a high prevalence of undiagnosed mental disorders in these women attending a HIV clinic. Their ART adherence was comparatively higher with low rates of adherence to clinic appointment. Depression, anxiety and alcohol use disorder in these women was not associated with clinic appointment or ART adherence. Recommendations: Although no association was noted between the assessed mental health disorders and the adherence measures assessed, there was a significant burden of undiagnosed mental disorders. Therefore, there is urgent need to build health care worker/system capacity to diagnose and manage mental disorders to ensure optimal health outcomes.