We examined the relationship between structural barriers to antiretroviral therapy and quality of life among 291 antiretroviral therapy users in South Africa. We found significant relationships between structural barriers to clinical attendance and pill taking and various dimensions of quality of life. Psychological distress was not found to be a mediator between structural barriers to clinic attendance and indicators of health-related quality of life, although it was a potential mediator between structural barriers to pill taking and some dimensions of quality of life. Psychological distress partially mediated the relationship between structural barriers to pill taking and physical well-being and between structural barriers to pill taking and emotional well-being.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2.
Aranda-NaranjoB. (2004). Quality of life in the HIV-positive patient: Implications and consequences. Journal of the Association of Nurses in AIDS Care, 15(5), 20–27. doi:10.1177/1055329004269183
3.
BasavarajK. H.NavyaM. A.RashmiR. (2010). Quality of life in HIV/AIDS. Indian Journal of Sexually Transmitted Diseases, 31(2), 75–80. doi:10.4103/0253-7184.74971
4.
BreenA.SwartzL.JoskaJ.FlisherA. J.CorrigallJ. (2007). Adherence to treatment in poorer countries: A new research direction?Psychiatric Services (Washington, D.C.), 58, 567–568. doi:10.1176/appi.ps.58.4.567
5.
ByrneS.PetryN. M. (2013). Reliability and validity of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) in patients with drug and alcohol use disorders. AIDS Care, 25, 118–125. doi:10.1080/09540121.2012.687811
6.
CellaD. F.McCainN. L.PetermanA. H.MoF.WolenD. (1996). Development and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 5, 450–463.
7.
CoetzeeB.KageeA. (2013). The development of an inventory to assess the structural barriers to clinic attendance and pill-taking amongst users of antiretroviral therapy. AIDS and Behavior, 17, 319–328. doi:10.1007/s10461-012-0374-z
8.
CoetzeeB.KageeA.VermeulenN. (2011). Structural barriers to adherence to antiretroviral therapy in a resource-constrained setting: The perspectives of health care providers. AIDS Care, 23, 146–151. doi:10.1080/09540121.2010.498874
9.
CoetzeeD.BoulleA.HildebrandK.AsselmanV.Van CutsemG.GoemaereE. (2004). Promoting adherence to antiretroviral therapy: The experience from a primary care setting in Khayelitsha, South Africa. AIDS (London, England), 18(Suppl. 3), S27–S31.
10.
CoyneJ. C.SmithD. A. (1991). Couples coping with a myocardial infarction: A contextual perspective on wives’ distress. Journal of Personality and Social Psychology, 61, 404–412.
11.
HairJ. F.BlackW. C.BabinB. J.AndersonR. E. (2010). Multivariate data analysis: a global perspective (7th ed.). Upper Saddle River, NJ: Pearson Education.
12.
HardonA. P.AkurutD.ComoroC.EkezieC.IrundeH. F.GerritsT.LaingR. (2007). Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa. AIDS Care, 19, 658–665. doi:10.1080/09540120701244943
13.
HoughR. L.LandsverkJ. A.StoneJ. D.JacobsenG. R. (1983). Comparison of psychiatric screening questionnaires for primary care patients (Final Report for NIMH contract No. 278-281-0036). National Institute of Mental Health, Bethesda.
14.
KageeA. (2005). Symptoms of distress and posttraumatic stress among South African former political detainees. Ethnicity & Health, 10, 169–179. doi:10.1080/13557850500071244
15.
KageeA. (2013). Training lay counsellors to provide psychosocial support to ART users: Successes and failures. AIDS Care, 25, 496–502. doi:10.1080/09540121.2012.712672
16.
KageeA.FreemanM. (2008). Mental health and physical health. In QuahS.HeggenhougenK. (Eds.), International encyclopedia of public health (pp. 354–364). San Diego, CA: Academic Press.
17.
KageeA.RemienR. H.BerkmanA.HoffmanS.CamposL.SwartzL. (2011). Structural barriers to ART adherence in Southern Africa: Challenges and potential ways forward. Global Public Health, 6, 83–97. doi:10.1080/17441691003796387
18.
KalichmanS. C.SimbayiL. (2004). Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care, 16, 572–580. doi:10.1080/09540120410001716360
19.
MillsE. J.NachegaJ. B.BuchanI.OrbinskiJ.AttaranA.SinghS.. . .BangsbergD. R. (2006). Adherence to antiretroviral therapy in sub-Saharan Africa and North America: A meta-analysis. JAMA: The Journal of the American Medical Association, 296, 679–690. doi:10.1001/jama.296.6.679
NelA.KageeA. (2013). The relationship between depression, anxiety and medication adherence among patients receiving antiretroviral treatment in South Africa. AIDS Care, 25, 948–955. doi:10.1080/09540121.2012.748867
22.
OguntibejuO. O. (2012). Quality of life of people living with HIV and AIDS and antiretroviral therapy. HIV/AIDS (Auckland, New Zealand), 4, 117–124. doi:10.2147/HIV.S32321
23.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
24.
ShriverM. D.EverettC.MorinS. F. (2000). Structural interventions to encourage primary HIV prevention among people living with HIV. AIDS (London, England), 14(Suppl. 1), S57–S62.
25.
TullerD. M.BangsbergD. R.SenkunguJ.WareN. C.EmenyonuN.WeiserS. D. (2010). Transportation costs impede sustained adherence and access to HAART in a clinic population in Southwestern Uganda: A qualitative study. AIDS and Behavior, 14, 778–784. doi:10.1007/s10461-009-9533-2
26.
WareN. C.WyattM. A.TugenbergT. (2006). Social relationships, stigma and adherence to antiretroviral therapy for HIV/AIDS. AIDS Care, 18, 904–910. doi:10.1080/09540120500330554
27.
WebsterK.CellaD.YostK. (2003). The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: Properties, applications, and interpretation. Health and Quality of Life Outcomes, 1, 79. doi:10.1186/1477-7525-1-79
28.
WeiserS. D.TullerD. M.FrongilloE. A.SenkunguJ.MukiibiN.BangsbergD. R. (2010). Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PLoS One, 5(4), e10340. doi:10.1371/journal.pone.0010340
29.
The WHOQOL Group. (1998). The World Health Organization Quality of Life Assessment (WHOQOL): Development and general psychometric properties. Social Science & Medicine, 46, 1569–1585.
30.
YoungS.WheelerA. C.McCoyS. I.WeiserS. D. (2013). A review of the role of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS. AIDS and Behavior. Advance online publication. doi:10.1007/s10461-013-0547-4
