Symptom management in HIV/AIDS is a critical issue that influences the quality of
life of those living with the disease. Although the goals of treating the numbers
living with HIV/AIDS have not yet been achieved, availability of antiretroviral therapies
(ARVs) has been expanded to many clinical settings in KwaZulu-Natal, the epicenter
of HIV infection in South Africa. The South African Department of Health (2007) estimates
indicate that 5.54 million South Africans are living with HIV/AIDS, whereas UNAIDS
(2007) estimates suggest that 18.8% of the population in South Africa is affected.
Because the symptom experience may influence adherence to ARVs and quality of life,
this study focused on the prevalence of symptoms reported by patients (N = 149) diagnosed
with HIV/AIDS and adherence to medications and appointments. Self-report data were
obtained from this community-based sample of HIV-infected patients who received care
in outpatient clinics in Durban, KwaZulu-Natal, South Africa. With an average of three
side effects, the most frequently reported by the study participants were fatigue/tiredness
(41%), rashes (40%), headaches (32%), insomnia (31%), sadness (24%), disturbing dreams
(23%), numbness (22%), pain (22%), and self-appearance (20%). On a scale of 1 to 10
(10 being worst possible), those with symptoms reported an average intensity of 4.2
(SD = 2.0), and the degree to which symptoms affected activity levels was 3.2 (SD
= 2.2). Although intensity of symptoms and effects on activity levels were strongly
correlated (r = .78, p < .001), there were no significant relationships between adherence
and the intensity of symptoms or the relationship of symptoms with activity levels.
Logistic regression analyses indicate that the presence of a greater number of symptoms
was not associated with greater adherence (odds ratio = 2.27, 95% confidence interval
= 0.60-8.70, ns). However, those who reported higher adherence were 1.5 times more
likely to report greater physical health than low adherers (p = .04). High adherers
were also 1.6 times more likely to report greater psychological health than low adherers
(p = .03). This suggests that further study is needed to investigate adherence motivations
for those living with HIV/AIDS in South Africa because adherence seems not to be linked
to the frequency of symptoms or limitations on activity related to symptoms.
Copyright © 2011 Elsevier Inc. All rights reserved.