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Mental and Physical Health Challenges Among HIV Outpatients in East Africa

This observational study examines multidimensional health issues faced by HIV outpatients in East Africa. The study assesses physical, psychological, and social problems among patients in Kenya and Uganda, highlighting the need for comprehensive care protocols. The findings emphasize the impacts of these problems on quality of life, treatment adherence, and overall outcomes in HIV management.

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Mental and Physical Health Challenges Among HIV Outpatients in East Africa

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  1. Mental and physical health and multidimensional problems among HIV outpatients in East Africa: a multicentre observational study Richard Harding1, Victoria Simms1, Suzanne Penfold1, Eve Namisango2, Tony Powell2, Faith Mwangi-Powell2, Julia Downing2, Scott Moreland3, Irene J Higginson11) King’s College London, Cicely Saunders Institute. 2) African Palliative Care Association, Uganda. 3) MEASURE Evaluation, USA. Cicely Saunders Institute Department of Palliative Care, Policy & Rehabilitation King’s College London http://www.csi.kcl.ac.uk/

  2. Background • Problems (physical, psychological, social, spiritual) persist: • from diagnosis (Simms 2011), alongside ART (Lowther 2014) • Yet most investigation is in advanced disease (Harding 2012/13/14) • WHO defines “health” as “complete physical, psychological and social wellbeing” • WHO recommends assessment and management of these problems throughout disease trajectory • PEPFAR funding has decreased mortality (Bendavid 2009) and vertical transmission (Reynolds 2008) • Is optimal benefit from PROM perspective being achieved?

  3. Aim • To measure patient wellbeing using PROMS among HIV outpatients at 12 PEPFAR-funded facilities in Kenya & Uganda, and to determine associations with patent problems • MOS-HIV (Quality of life) • POS (physical/psychological/social/spiritual problems)

  4. Results #1 N=1,337 Worst problems on POS

  5. Results #2 N=1,337 Associations with outcomes (GEE) NOTE: No significance gender, age

  6. Conclusions • We risk reducing HIV services to “test & treat” • Simple assessment and care protocols are feasible and urgently required • As greater numbers live with HIV long-term, we must ensure this is an optimal QoL • Psychosocial needs are greatest • Pain is also endured • ART is central but not the complete answer • These problems are shown to affect key outcomes of QoL, adherence, switching, suicidal ideation, virological rebound (Harding JIAS 2014) • We CAN improve these outcomes (TOPCare trial WEPE219)

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