Mental health and antiretroviral therapy: an exploration of the association between depression and ART adherence among the youth in Lilongwe, Malawi
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Date
2021-09-15
Authors
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Publisher
Kamuzu University of Health Sciences
Abstract
Type of study: A crosssectional mixed methods design study with Quantitative and Qualitative
approaches with each provising equal weight (QUANT-QUAL).
Problem: Martin Preus Centre (MPC) provides comprehensive HIV services to youths aged 15-
24. However, from October, 2020 – March, 2021, 154 youths aged 15-24 either self -referred or
provider initiated referred for psychosocial counselling services due to poor ART adherence
related factors. Despite collaborative efforts in improving ART adherence among youth in
Lilongwe, MPC has 28.5 % of ART non adherence. Therefore, this study intends to measure the
association between depression and ART non-adherence among the youth in Lilongwe.
Main objective
To establish the association between depression and ART non- adherence among the youth
in Lilongwe
Specific Objectives
To determine the characteristics of depression among the youth on ART at MPC in
Lilongwe
To explore the factors leading to depression among the youth at MPC in Lilongwe
To assess ART adherence among the youth on ART at MPC in Lilongwe
To examine the association between depression and ART non- adherence among the youth
at MPC in Lilongwe
Methodology: The study will be conducted at Lighthouse Trust- Martin Preus Centre (MPC) at
Bwaila Hospital in urban city of Lilongwe, Malawi.
310 participants will recruited in the study comprising of psychosocial counsellors, ART providers
and youths aged 15-24 accessing ART services at MPC.
Quantitatively: Data will be collected using Patient Health Questionnaire (PHQ 9) scale for
depression assessment. Secondary data will be extracted from the Electronic Medical Records
(EMR) to assess youths ART adherence. The quantitative data will be analyzed using Stata. In
measuring the association between depression (predictor variable) and ART adherence (Outcome
variable) comparison of the proportion of patients with poor ART adherence among the group with
depression versus those without depression will be done. Furthermore, multivariable logistic
regression model and chi-square test will be used to compute Odds Ratio and compare the various
variables in proportions whenever it will be applicable.
Qualitatively: Data will be collected using semi structured interview guide on In-depth interviews
(IDI) .The IDI’s will be guided with open ended questions which will be audio recorded and
backed with field notes.Themantic content analsysis will be conducted in qualitative data aided by
NVivo software.
Expected findings: Study is expected to measure the association between depression and ART nonadherence
amongst the youth accessing ART services at MPC.
Dissemination: A well detailed report of findings will be prepared and disseminated to the
implementing partner Health Lighthouse Trust- MPC clinic and other relevant stake holders
including Ministry of College of Medicine and Research Ethics Committee, College of Medicine
library for student’s reference and further study gap identification. The results shall further be
published in relevant peer reviewed journals.
Description
Keywords
Research Subject Categories::MEDICINE