TY - JOUR
T1 - Neurocognitive and mental health outcomes and association with quality of life among adults living with HIV
T2 - a cross-sectional focus on a low-literacy population from coastal Kenya
AU - Nyongesa, Moses Kachama
AU - Mwangala, Patrick N.
AU - Mwangi, Paul
AU - Kombe, Martha
AU - Newton, Charles R.J.C.
AU - Abubakar, Amina A.
N1 - Funding Information:
Funding This work was supported by funding from the Medical Research Council (Grant number MR/M025454/1) to AAA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union. During this work, MKN was supported by the Wellcome Trust Master’s Fellowship in Public Health and Tropical Medicine (Grant number 201310/Z/16/Z).
Publisher Copyright:
© Author(s) (or their employer(s)) 2018.
PY - 2018
Y1 - 2018
N2 - Objectives Our aim was to compare the neurocognitive performance and mental health outcome of adults living with HIV on antiretroviral therapy with that of community controls, all of low literacy. Furthermore, we also wanted to explore the relationship of these outcomes with quality of life among adults living with HIV. study design This was a descriptive cross-sectional study. setting The study was conducted in Kilifi County, a region located at the Kenyan coast. Participants The participants consisted of a consecutive sample of 84 adults living with HIV and 83 randomly selected community controls all with ≤8 years of schooling. All participants were assessed for non-verbal intelligence, verbal working memory and executive functioning. The Major Depression Inventory and a quality of life measure (RAND SF-36) were also administered. results Using analysis of covariance, we found no statistically significant group differences between adults living with HIV and community controls in all the neurocognitive tests except for a marginal difference in the non-verbal intelligence test (F (1, 158)=3.83, p=0.05). However, depressive scores of adults living with HIV were significantly higher than those of controls (F (1, 158)=11.56, p<0.01). Also, quality of life scores of adults living with HIV were significantly lower than those of controls (F (1, 158)=4.62, p=0.03). For the HIV-infected group, results from multivariable linear regression analysis showed that increasing depressive scores were significantly associated with poorer quality of life (β=-1.17, 95% CI-1.55 to –0.80; p<0.01). Conclusion Our findings suggest that adults of low-literacy levels living with HIV and on antiretroviral medication at the Kenyan coast do not have significant cognitive deficits compared with their uninfected counterparts. However, their mental health, compared with that of HIV-uninfected adults, remains poorer and their quality of life may deteriorate when HIV and depressive symptoms co-occur.
AB - Objectives Our aim was to compare the neurocognitive performance and mental health outcome of adults living with HIV on antiretroviral therapy with that of community controls, all of low literacy. Furthermore, we also wanted to explore the relationship of these outcomes with quality of life among adults living with HIV. study design This was a descriptive cross-sectional study. setting The study was conducted in Kilifi County, a region located at the Kenyan coast. Participants The participants consisted of a consecutive sample of 84 adults living with HIV and 83 randomly selected community controls all with ≤8 years of schooling. All participants were assessed for non-verbal intelligence, verbal working memory and executive functioning. The Major Depression Inventory and a quality of life measure (RAND SF-36) were also administered. results Using analysis of covariance, we found no statistically significant group differences between adults living with HIV and community controls in all the neurocognitive tests except for a marginal difference in the non-verbal intelligence test (F (1, 158)=3.83, p=0.05). However, depressive scores of adults living with HIV were significantly higher than those of controls (F (1, 158)=11.56, p<0.01). Also, quality of life scores of adults living with HIV were significantly lower than those of controls (F (1, 158)=4.62, p=0.03). For the HIV-infected group, results from multivariable linear regression analysis showed that increasing depressive scores were significantly associated with poorer quality of life (β=-1.17, 95% CI-1.55 to –0.80; p<0.01). Conclusion Our findings suggest that adults of low-literacy levels living with HIV and on antiretroviral medication at the Kenyan coast do not have significant cognitive deficits compared with their uninfected counterparts. However, their mental health, compared with that of HIV-uninfected adults, remains poorer and their quality of life may deteriorate when HIV and depressive symptoms co-occur.
UR - http://www.scopus.com/inward/record.url?scp=85069617654&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-023914
DO - 10.1136/bmjopen-2018-023914
M3 - Article
C2 - 30224402
AN - SCOPUS:85069617654
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e023914
ER -
