The impact of highly active antiretroviral therapy on activities of daily living in HIV-infected adults in South Africa
Department of Community and Preventive Medicine, University of Rochester, Box 644, 601 Elmwood Ave, Rochester, NY 14642, United States; Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Earth Institute, Columbia University, New York, NY, United States; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Johns Hopkins University, School of Medicine, Baltimore, MD, United States
This study investigated the relationship between highly active antiretroviral therapy (HAART) and instrumental activities of daily living (IADLs) among two clinical cohorts in South Africa. Between 2003 and 2008 structured questionnaires were administered to HIV-positive patients attending outpatient clinics at an urban hospital (Soweto, n = 3,081) and a rural hospital (Acornhoek, n = 1,247). Among those receiving help, an average of 4.8 and 5.1 h of assistance with IADLs daily was reported (rural and urban participants, respectively), with the patient's mother and children assisting the most. Participants on HAART were 17 and 41% less likely to receive assistance with IADLs in the rural and urban cohorts, respectively, after adjusting for demographic characteristics, healthcare utilization, and CD4 counts. HAART significantly decreased the IADL assistance among patients in South Africa. Alongside clinical benefits, HAART has the potential to reduce the burden of HIV-related care, potentially extending wider social and economic gains to other family members. © 2010 Springer Science+Business Media, LLC.
adult; aged; article; CD4 lymphocyte count; cohort analysis; daily life activity; female; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; male; middle aged; outpatient department; quality of life; questionnaire; rural population; socioeconomics; South Africa; treatment outcome; urban population; virology; virus load; Activities of Daily Living; Adult; Aged; Ambulatory Care Facilities; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Cohort Studies; Female; HIV Infections; Humans; Male; Middle Aged; Quality of Life; Questionnaires; Rural Population; Socioeconomic Factors; South Africa; Treatment Outcome; Urban Population; Viral Load; Young Adult