Haas, Andreas D; Lienhard, Raphael; Didden, Christiane; Cornell, Morna; Folb, Naomi; Boshomane, Tebatso M G; Salazar-Vizcaya, Luisa; Ruffieux, Yann; Nyakato, Patience; Wettstein, Anja E; Tlali, Mpho; Davies, Mary-Ann; von Groote, Per; Wainberg, Milton; Egger, Matthias; Maartens, Gary; Joska, John A (2023). Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study. AIDS and behavior, 27(6), pp. 1849-1861. Springer 10.1007/s10461-022-03916-x
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We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector HIV programme to examine adherence and viral non-suppression (viral load > 400 copies/mL) of participants with (20,743, 38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted risk ratio (aRR) 1.55, 95% confidence interval (CI) 1.22-1.96], substance use disorders (aRR 1.53, 95% CI 1.19-1.97), serious mental disorders (aRR 1.30, 95% CI 1.09-1.54), and depression (aRR 1.19, 95% CI 1.10-1.28) when compared with patients without mental health diagnoses. The risk of viral non-suppression was also higher among males, adolescents (15-19 years), and young adults (20-24 years). Our study highlights the need for psychosocial interventions to improve HIV treatment outcomes-particularly of adolescents and young adults-and supports strengthening mental health services in HIV treatment programmes.
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