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. 2023 Apr 20;23(1):274.
doi: 10.1186/s12888-023-04782-0.

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

Flavio M Mandlate  1   2 , M Claire Greene  3 , Luis F Pereira  4 , Maria Lidia Gouveia  5   6 , Jair Jesus Mari  6 , Francine Cournos  4 , Cristiane S Duarte  4 , Maria A Oquendo  7 , Marcelo Feijó Mello #  6 , Milton L Wainberg #  4
Affiliations

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

Flavio M Mandlate et al. BMC Psychiatry. .

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.

Keywords: ART adherence; HIV/AIDS treatment; Mental disorders; Mozambique.

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Conflict of interest statement

Dr. Oquendo receives royalties from the Research Foundation for Mental Hygiene for the Columbia Suicide Severity Rating Scale’s commercial use and owns shares in Mantra, Inc. She serves as an advisor to Alkermes and Fundacion Jimenez Diaz (Madrid). Her family owns stock in Bristol Myers Squibb. The other authors declare no competing interests.

Figures

Fig. 1a
Fig. 1a
Distribution in level of medication adherence by mental disorder categories in Mozambique (n = 395)
Fig. 1b
Fig. 1b
Distribution in level of medication adherence by mental disorder diagnoses in Mozambique (n = 395)
See this image and copyright information in PMC

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