Quality of life of people living with HIV and their adherence to antiretroviral therapy in Bukavu City, Democratic Republic of the Congo

Abstract

Background The benefits of Highly Active Antiretroviral Therapy (HAART) for people living with HIV/AIDS (PLHIV) include immune system strengthening, viral load suppression, and improved health-related quality of life (HRQoL). Objectives To compare the HRQoL of PLHIV attending ART clinics versus PLHIV visiting traditional healers’ (THs) offices, to assess the adherence of PLHIV to ART, to identify possible predictors of non-adherence of PLHIV to ART and QoL and to estimate the proportion of patients with HIV referred by THs to health centers in Bukavu. Methods Between February and June 2023, a comparative cross-sectional study was carried out involving 150 HIV-positive patients who were attending ART clinics and 150 PLHIV who were visiting the offices of THs in the three Bukavu urban health zones. The World Health Organization Quality of Life questionnaire (WHOQoL-BREF) and a self-reported questionnaire measuring antiretroviral medication adherence were used to collect data. Regression models were used to identify the predictors of no adherence to ART and the QoL of PLHIV. Results PLHIV attending ART clinics had higher mean scores in all QoL domains compared to those attending THs' offices. About 84% of participants were compliant with ART. Predictors associated with non-adherence to ART included: illiterate participants [OR = 23.3 (95% CI: 1.23–439.5), p = 0.004] and divorced or separated participants [OR = 10.3 (95% CI: 1.12–94.4), p = 0.034]. The proportion of patients with HIV/AIDS referred to ART clinics by THs was only 10.7%. Conclusion and recommendation PLHIV visiting ART clinics had a better QoL compared to PLHIV attending THs’ offices. The rate of adherence to ART among PLHIV who attended ART clinics was high. It is recommended to refer PLHIV visiting THs to the ART clinics for better QoL.