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.
