Quality of life among adult patients living with HIV/AIDS taking antiretroviral drugs
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Background: Zimbabwe’s response to the HIV/AIDS pandemic in terms of prevention, testing, counseling and treatment has been commendable but inadequate in terms of provision of rehabilitation services to HIV-infected individuals. Objectives: To determine the prevalence and extent of activity limitations and participation restrictions (disabilities) experienced by adults living with HIV/AIDS who are on Antiretroviral drugs (ARVs) and the factors associated with quality of life as assessed by the International Classification of Functioning, Disability and Health (ICF). Study variables: type of ARV, period on ARVs, last CD4 count, physical and mental health, previous injury, use of assistive devices, having an assistant, and demographic characteristics. Outcome variables: quality of life (total score), domain total scores, reduction and stopping of usual activities. Methods: A cross sectional analytical study was done with 59 consenting HIV positive adults on antiretroviral drugs attending an opportunistic infection clinic. An ICF-based interview questionnaire was administered on consecutive patients. Ethical clearance was granted. Data Analysis: Descriptive statistics were used to describe the distributions of participants according to demographic characteristics, clinical profile and prevalence of activity limitations and participation restrictions. Multivariate analysis was done to determine the factors that predicted quality of life. Level of significance was set at 5%. Results: The mean age of participants was 41 years (+/- 9.3), 56% were female, 54% were married and 30.5% were widowed. Median period on ARVs was 13 months (I.Q.R 3-29) and median last CD4 count was 189.5 (I.Q.R 114-278). Thirty-two (54%) were on Stalanev. About 36% and 61% had stopped or reduced their usual activities due to the illness respectively. Most affected aspects were walking (71%), fine hand use (41%), lifting & carrying objects (71%), shopping (55%), housework (55%), remunerative employment (56%) and economic self-sufficiency (79%). The support and relationships and attitudes of health professionals (86% and 88%) and immediate family (75% and 78%) were the cited major environmental facilitators. Factors statistically significantly associated with quality of life were physical health (p= 0.01), mental & emotional health (p= 0.04), and use of assistive devices (p= 0.02). Period on ARVs and last CD4 count were not statistically significantly associated with quality of life. Conclusion: HIV-related disabilities are prevalent even among those on antiretroviral drugs and their quality of life is reduced, hence the need to scale up rehabilitation services for them.