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Higher Quality of Life and Lower Depression for People on ART in Uganda as Compared to a Community Control Group

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  • Faith Martin
  • Steve Russell
  • Janet Seeley

Abstract

Provision of antiretroviral treatment (ART) to people living with HIV (PLWH) has increased globally. Research measuring whether ART restores subjective well-being to “normal” levels is lacking, particularly in resource limited settings. The study objectives are to compare quality of life and depression symptoms for PLWH on ART to a general community population and to explore factors to explain these differences, including socio-economic status and the impact of urban or rural residence. PLWH on ART (n = 263) were recruited from ART delivery sites and participants not on ART (n = 160) were recruited from communities in Wakiso District, Uganda. Participants were interviewed using the translated World Health Organisation Quality of Life brief measure, the Hopkins Symptom Checklist depression section, and questions about socio-economic status, residence as urban or rural and, for PLWH on ART, self-reported adherence and use of HIV counselling. Compared to the community sample and controlling for location of residence, PLWH on ART had significantly higher quality of life (QOL) for physical, psychological and environment domains, but not the social domain. These differences were not due to socio-economic status alone. Depression scores were significantly lower for PLWH on ART. Both comparisons controlled for the effect of location of residence. People on ART self-reported high adherence and the majority had used HIV counselling services. Our findings show better QOL amongst PLWH on ART compared to a general community sample, which cannot be explained solely by differences in socio-economic status nor location of residence. The general community sample results point towards the challenges of life in this setting. Access to health services may underpin this difference and further research should explore this finding, in addition to identification of psychological mechanisms that relate to better QOL. ART provision infrastructure has clear benefits. Further work should consider sustainability and replication for other health conditions.

Suggested Citation

  • Faith Martin & Steve Russell & Janet Seeley, 2014. "Higher Quality of Life and Lower Depression for People on ART in Uganda as Compared to a Community Control Group," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-8, August.
    • Handle: RePEc:plo:pone00:0105154
    DOI: 10.1371/journal.pone.0105154
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    References listed on IDEAS

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    1. Bandy Lee & Sylvia F. Kaaya & Jessie K. Mbwambo & Mary C. Smith-Fawzi & Melkizedek T. Leshabari, 2008. "Detecting Depressive Disorder With the Hopkins Symptom Checklist-25 in Tanzania," International Journal of Social Psychiatry, , vol. 54(1), pages 7-20, January.
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    3. Robert Cummins, 1996. "The domains of life satisfaction: An attempt to order chaos," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 38(3), pages 303-328, January.
    4. Russell, Steven & Seeley, Janet, 2010. "The transition to living with HIV as a chronic condition in rural Uganda: Working to create order and control when on antiretroviral therapy," Social Science & Medicine, Elsevier, vol. 70(3), pages 375-382, February.
    5. Martin W G Brinkhof & Mar Pujades-Rodriguez & Matthias Egger, 2009. "Mortality of Patients Lost to Follow-Up in Antiretroviral Treatment Programmes in Resource-Limited Settings: Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 4(6), pages 1-9, June.
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    Cited by:

    1. Charlotte Bernard & François Dabis & Nathalie de Rekeneire, 2017. "Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-22, August.
    2. Elnur Rustamov & Tunzala Musayeva & Xalida Xalilova & Gultekin Ismayilova & Ulviyya Nahmatova, 2023. "Association between Self-Esteem and Smartphone Addiction: The Mediating Role of Self-Control," Technium Social Sciences Journal, Technium Science, vol. 46(1), pages 256-267, August.
    3. Steve Russell & Faith Martin & Flavia Zalwango & Stella Namukwaya & Ruth Nalugya & Richard Muhumuza & Joseph Katongole & Janet Seeley, 2016. "Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-16, January.

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