“I was thinking too much”: experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe
Identifieur interne : 001F14 ( Pmc/Curation ); précédent : 001F13; suivant : 001F15“I was thinking too much”: experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe
Auteurs : Khameer Kidia [Zimbabwe, États-Unis] ; Debra Machando [Zimbabwe] ; Tarisai Bere [Zimbabwe] ; Kirsty Macpherson [Royaume-Uni] ; Primrose Nyamayaro [Zimbabwe] ; Lucy Potter [Royaume-Uni] ; Tariro Makadzange [Zimbabwe] ; Ronald Munjoma [Zimbabwe] ; Marshall Marufu [Zimbabwe] ; Ricardo Araya ; Steven Safren [États-Unis] ; Conall O'Cleirgh [États-Unis] ; Dixon Chibanda [Zimbabwe] ; Melanie Abas [Zimbabwe, Royaume-Uni]Source :
- Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2015.
Abstract
To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings.
In-depth qualitative interviews were conducted with 47 (female =31) HIV-positive adults who scored above the cut-point on a locally-validated scale for common mental disorders. Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team.
The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of common mental disorders (“thinking too much”, changes to appetite and sleep, “burdened heart”, and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with common mental disorders. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income generating activities, and family engagement in mental health care.
Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce common mental disorders and poor adherence to antiretroviral therapy.
Url:
DOI: 10.1111/tmi.12502
PubMed: 25754063
PubMed Central: 4500937
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sort="Machando, Debra" uniqKey="Machando D" first="Debra" last="Machando">Debra Machando</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Bere, Tarisai" sort="Bere, Tarisai" uniqKey="Bere T" first="Tarisai" last="Bere">Tarisai Bere</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Macpherson, Kirsty" sort="Macpherson, Kirsty" uniqKey="Macpherson K" first="Kirsty" last="Macpherson">Kirsty Macpherson</name><affiliation wicri:level="1"><nlm:aff id="A3"> King's College 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last="Marufu">Marshall Marufu</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Araya, Ricardo" sort="Araya, Ricardo" uniqKey="Araya R" first="Ricardo" last="Araya">Ricardo Araya</name><affiliation><nlm:aff id="A4"><italic>London School of Hygiene and Tropical Medicine, UK</italic></nlm:aff></affiliation></author><author><name sortKey="Safren, Steven" sort="Safren, Steven" uniqKey="Safren S" first="Steven" last="Safren">Steven Safren</name><affiliation wicri:level="1"><nlm:aff id="A5"> Harvard Medical School, Department of Psychiatry, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea> Harvard Medical School, Department of Psychiatry, Boston, 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last="Abas">Melanie Abas</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A3"> King's College London, Institute of Psychiatry, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea> King's College London, Institute of Psychiatry, London</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25754063</idno><idno type="pmc">4500937</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500937</idno><idno type="RBID">PMC:4500937</idno><idno type="doi">10.1111/tmi.12502</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001F15</idno><idno type="wicri:explorRef" wicri:stream="Pmc" 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xml:lang="fr">États-Unis</country><wicri:regionArea> Icahn School of Medicine at Mount Sinai, Arnhold Global Health Institute, New York</wicri:regionArea></affiliation></author><author><name sortKey="Machando, Debra" sort="Machando, Debra" uniqKey="Machando D" first="Debra" last="Machando">Debra Machando</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Bere, Tarisai" sort="Bere, Tarisai" uniqKey="Bere T" first="Tarisai" last="Bere">Tarisai Bere</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Macpherson, Kirsty" sort="Macpherson, Kirsty" uniqKey="Macpherson K" first="Kirsty" last="Macpherson">Kirsty Macpherson</name><affiliation wicri:level="1"><nlm:aff id="A3"> King's College London, Institute of Psychiatry, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea> King's College London, Institute of Psychiatry, London</wicri:regionArea></affiliation></author><author><name sortKey="Nyamayaro, Primrose" sort="Nyamayaro, Primrose" uniqKey="Nyamayaro P" first="Primrose" last="Nyamayaro">Primrose Nyamayaro</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Potter, Lucy" sort="Potter, Lucy" uniqKey="Potter L" first="Lucy" last="Potter">Lucy Potter</name><affiliation wicri:level="1"><nlm:aff id="A3"> King's College London, Institute of Psychiatry, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea> King's College London, Institute of Psychiatry, London</wicri:regionArea></affiliation></author><author><name sortKey="Makadzange, Tariro" sort="Makadzange, Tariro" uniqKey="Makadzange T" first="Tariro" last="Makadzange">Tariro Makadzange</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Munjoma, Ronald" sort="Munjoma, Ronald" uniqKey="Munjoma R" first="Ronald" last="Munjoma">Ronald Munjoma</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Marufu, Marshall" sort="Marufu, Marshall" uniqKey="Marufu M" first="Marshall" last="Marufu">Marshall Marufu</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Araya, Ricardo" sort="Araya, Ricardo" uniqKey="Araya R" first="Ricardo" last="Araya">Ricardo Araya</name><affiliation><nlm:aff id="A4"><italic>London School of Hygiene and Tropical Medicine, UK</italic></nlm:aff></affiliation></author><author><name sortKey="Safren, Steven" sort="Safren, Steven" uniqKey="Safren S" first="Steven" last="Safren">Steven Safren</name><affiliation wicri:level="1"><nlm:aff id="A5"> Harvard Medical School, Department of Psychiatry, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea> Harvard Medical School, Department of Psychiatry, Boston, MA</wicri:regionArea></affiliation></author><author><name sortKey="O Cleirgh, Conall" sort="O Cleirgh, Conall" uniqKey="O Cleirgh C" first="Conall" last="O'Cleirgh">Conall O'Cleirgh</name><affiliation wicri:level="1"><nlm:aff id="A5"> Harvard Medical School, Department of Psychiatry, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea> Harvard Medical School, Department of Psychiatry, Boston, MA</wicri:regionArea></affiliation></author><author><name sortKey="Chibanda, Dixon" sort="Chibanda, Dixon" uniqKey="Chibanda D" first="Dixon" last="Chibanda">Dixon Chibanda</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation></author><author><name sortKey="Abas, Melanie" sort="Abas, Melanie" uniqKey="Abas M" first="Melanie" last="Abas">Melanie Abas</name><affiliation wicri:level="1"><nlm:aff id="A1"> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea> University of Zimbabwe College of Health Sciences, Harare</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A3"> King's College London, Institute of Psychiatry, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea> King's College London, Institute of Psychiatry, London</wicri:regionArea></affiliation></author></analytic><series><title level="j">Tropical medicine & international health : TM & IH</title><idno type="ISSN">1360-2276</idno><idno type="eISSN">1365-3156</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings.</p></sec><sec id="S2"><title>Methods</title><p id="P2">In-depth qualitative interviews were conducted with 47 (female =31) HIV-positive adults who scored above the cut-point on a locally-validated scale for common mental disorders. Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team.</p></sec><sec id="S3"><title>Results</title><p id="P3">The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of common mental disorders (“thinking too much”, changes to appetite and sleep, “burdened heart”, and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with common mental disorders. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income generating activities, and family engagement in mental health care.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce common mental disorders and poor adherence to antiretroviral therapy.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9610576</journal-id><journal-id journal-id-type="pubmed-jr-id">20323</journal-id><journal-id journal-id-type="nlm-ta">Trop Med Int Health</journal-id><journal-id journal-id-type="iso-abbrev">Trop. Med. Int. Health</journal-id><journal-title-group><journal-title>Tropical medicine & international health : TM & IH</journal-title></journal-title-group><issn pub-type="ppub">1360-2276</issn><issn pub-type="epub">1365-3156</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25754063</article-id><article-id pub-id-type="pmc">4500937</article-id><article-id pub-id-type="doi">10.1111/tmi.12502</article-id><article-id pub-id-type="manuscript">NIHMS673745</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>“I was thinking too much”: experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kidia</surname><given-names>Khameer</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Machando</surname><given-names>Debra</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Bere</surname><given-names>Tarisai</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Macpherson</surname><given-names>Kirsty</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Nyamayaro</surname><given-names>Primrose</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Potter</surname><given-names>Lucy</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Makadzange</surname><given-names>Tariro</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Munjoma</surname><given-names>Ronald</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Marufu</surname><given-names>Marshall</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Araya</surname><given-names>Ricardo</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Safren</surname><given-names>Steven</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>O'Cleirgh</surname><given-names>Conall</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Chibanda</surname><given-names>Dixon</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Abas</surname><given-names>Melanie</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A3">3</xref></contrib></contrib-group><aff id="A1"><label>1</label> University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</aff><aff id="A2"><label>2</label> Icahn School of Medicine at Mount Sinai, Arnhold Global Health Institute, New York, USA</aff><aff id="A3"><label>3</label> King's College London, Institute of Psychiatry, London, UK</aff><aff id="A4"><label>4</label><italic>London School of Hygiene and Tropical Medicine, UK</italic></aff><aff id="A5"><label>5</label> Harvard Medical School, Department of Psychiatry, Boston, MA, USA</aff><author-notes><corresp id="CR1"><bold>Corresponding author</bold>: Khameer Kidia, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe. Phone: +263-4-882238. <email>kkidia@gmail.com</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>8</day><month>4</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>23</day><month>3</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>7</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>7</month><year>2016</year></pub-date><volume>20</volume><issue>7</issue><fpage>903</fpage><lpage>913</lpage><pmc-comment>elocation-id from pubmed: 10.1111/tmi.12502</pmc-comment>
<abstract><sec id="S1"><title>Objective</title><p id="P1">To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings.</p></sec><sec id="S2"><title>Methods</title><p id="P2">In-depth qualitative interviews were conducted with 47 (female =31) HIV-positive adults who scored above the cut-point on a locally-validated scale for common mental disorders. Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team.</p></sec><sec id="S3"><title>Results</title><p id="P3">The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of common mental disorders (“thinking too much”, changes to appetite and sleep, “burdened heart”, and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with common mental disorders. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income generating activities, and family engagement in mental health care.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce common mental disorders and poor adherence to antiretroviral therapy.</p></sec></abstract><kwd-group><kwd>HIV/AIDS</kwd><kwd>depression</kwd><kwd>mental health</kwd><kwd>adherence</kwd><kwd>antiretroviral therapy</kwd><kwd>barriers</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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