Perceived changes and challenges in the quality of life of HIV infected individuals on ART: A qualitative study in Uganda.
Abstract
Issues: It is widely recognized that HIV/AIDS affects both life expectancy and the quality of life of individuals, and that successful antiretroviral therapy (ART) will improve quality of life dramatically. This qualitative research documents the perceived changes and challenges in the quality of life of HIV-infected individuals 6-12 months after they started on ART. Description: Data were generated from six Focus Group Discussions, 3 conducted with men and 3 with women who were on ART for a period of 6-12 months as participants in the Development of antiretroviral Therapy in Africa (DART) Trial. A wrap-up discussion was held with health-care providers administering ART to this population, to verify and validate some of the findings. Lessons learned: Counselling was recognized to foster a positive attitude after first HIV testing and was crucial for individuals to cope with thoughts of death, depression and stigma. It helped them to comply with ART and to adopt safer sexual practices. Good counselling services are pivotal for the success of ART programmes. ART was reported to have improved physical health and appearance of recipients thus enabling them to return to their day-to-day activities. However, the positive effect of ART on participants' perceived quality of life was limited by stigma, pill burden, drug side effects and socio-economic constraints such as lack of employment and inability to meet basic needs like food and clothing. Our findings confirm the multidimensional nature of quality of life as an outcome measure for HIV-infected individuals in Africa. Recommendations: It should not be assumed that effective ART provision is sufficient in itself to lead to a major improvement of the perceived quality of life among persons living with HIV/AIDS. Good counselling and other additional support services may be required to consolidate the positive effects of ART.
Citation
Nyanzi Wakholi, B.; Medina Lara, A.; Munderi, P.; Gilks, C.F.; Grosskurth, H. Perceived changes and challenges in the quality of life of HIV infected individuals on ART: A qualitative study in Uganda. Presented at XVI International AIDS Conference, Toronto, Canada, 13-18 August 2006. (2006)