Psychiatric Disorders in Adolescents Living with HIV and Association with Antiretroviral Therapy Adherence in Sub-Sahara
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SUBSTANTIVE REVIEW
Psychiatric Disorders in Adolescents Living with HIV and Association with Antiretroviral Therapy Adherence in Sub‑Saharan Africa: A Systematic Review and Meta‑analysis Anthony A. Olashore1 · Saeeda Paruk2 · Oluyemi O. Akanni3 · Andrew Tomita4,5 · Bonginkosi Chiliza2 Accepted: 11 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract In sub-Saharan Africa (SSA), a systematic approach to exploring the prevalence of psychiatric disorders (PDs) and adherence to antiretroviral treatment (ART) in adolescents living with HIV (ALWHIV) is lacking. This study aimed to systematically review the studies conducted in SSA on the prevalence of PDs among ALWHIV and their association with ART adherence. A systematic search of all English studies assessing PDs among ALWHIV using the Web of Science, PubMed, and EBSCO databases was conducted between March 1 and September 30, 2019. Forty-two studies published between 2009 to 2019 met the inclusion criteria, of which 15 were included in the meta-analysis. The most common PDs were depression (0.24, 95% CI 0.14–0.36) and anxiety disorder (0.26, 95% CI 2–0.44). The available evidence could not conclude on the definitive association between PDs and ART adherence; therefore, further research is required. However, the need for mental health integration in the care for ALWHIV is evident. Keywords Adherence · Adolescents · HIV · Psychiatric disorders · Sub-Saharan Africa Resumen En África subsahariana (SSA), falta un enfoque sistemático para explorar la prevalencia de los trastornos psiquiátricos (PDs) y la adherencia al tratamiento antirretroviral (ART) en adolescentes que viven con el VIH (ALWHIV). Este estudio tuvo como objetivo revisar sistemáticamente los estudios realizados en la SSA sobre la prevalencia de PDs en ALWHIV y su asociación con la adherencia al ART. Se realizó una búsqueda sistemática de todos los estudios en inglés que evalúan PDs entre ALWHIV utilizando las bases de datos Web of Science, PubMed y EBSCO entre el 1 de marzo y el 30 de septiembre de 2019. Cuarenta y dos estudios publicados entre 2009 y 2019 cumplieron los criterios de inclusión, de los cuales 15 se incluyeron en el metanálisis. Los TP más frecuentes fueron depresión (0.24, 95% CI 0.14–0.36) y trastorno de ansiedad (0.26, 95% CI 2–0.44). La evidencia disponible no pudo concluir sobre la asociación definitiva entre los PDs y la adherencia al ART; por lo tanto, se requiere más investigación. Sin embargo, la necesidad de la integración de la salud mental en la atención de ALWHIV es evidente. * Anthony A. Olashore [email protected] Saeeda Paruk [email protected]
2
Oluyemi O. Akanni [email protected]
Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
3
Andrew Tomita [email protected]
Clinical Services, Federal Neuropsychiatric Hospital, Benin City, Edo State, Nigeria
4
KwaZulu‑Natal Research Innovation and Sequencing Platform, Nelson R Mandela School of Medicine, C
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