Assessment of Chronological Onset, Treatment Adherence and Quality of Life of People with Duo Diagnosis of Mental Disorders and HIV/AIDS at Ndera Neuropsychiatric Hospital

Abstract

Background: There is high inter-dependency and link of mental health disorders and HIV/AIDS as reported from different studies. Thus, this study assessed the chronological onset of HIV/AIDS and mental disorders, adherence to treatment and quality of life (QOL) in people with HIV/AIDS and mental health disorders at Ndera Neuropsychiatric Hospital.

Methods: A facility-based cross-sectional study that used MARS questionnaire to assess the adherence rate and the information on the QOL was collected using SF-36 questionnaire and translated in Kinyarwanda (Translated SF-36 and MARS tools). Group comparison of mean scores was done using t-test for normally distributed scores of quality of life domains then Mann Whitney U test and Kruskal Wallis test were used for skewed scores of quality of life domains. Results: The median age for our participants was 44.9 ± 10.34 years and the majority of participants (75.8%) were females. Of all participants, 56.03% were diagnosed with mental health disorders before being diagnosed with HIV whereas HIV infection was diagnosed before mental disorder in 43.97% of the participants. Of all participants, 17 participants (14.6%) were found to have poor adherence to their psychotropic medications while 5 participants (4.3%) were having poor to their ART medications. There was no observed significant difference in the adherence to both antipsychotics and ARTs across the chronology of diagnosis groups. Differences in QOL were observed in mean role limitation domain across age group and in mean role limitations due to physical activities (p=0.049) and in mean role limitations due to emotional problems across education backgrounds (0.004). A significant difference in the mean QOL in the energy/fatigue domain was also found across the living status (p=0.044) and in the general health domain between male and female participants (p=0.013). Conclusion: Of our study participants, HIV infection showed to have been diagnosed after the diagnosis of subsequent mental disorder. Patients with duo diagnosis of mental health and HIV are more likely to have poor adherence to their antipsychotics (14.6%) compared to adherence on their ART medications (4.3%). Patients with duo diagnosis of mental disorder and HIV have higher scores of QOL in physical functioning and poor scores of quality of life in social wellbeing and emotional functioning domain.