Abstract:
Objectives: Our aim was to compare the neurocognitive performance and mental health
outcome of adults living with HIV on antiretroviral therapy with that of community
controls, all of low literacy. Furthermore, we also wanted to explore the relationship of
these outcomes with quality of life among adults living with HIV.
Study design: This was a descriptive cross-sectional study.
Setting: The study was conducted in Kilifi County, a region located at the Kenyan coast.
Participants: The participants consisted of a consecutive sample of 84 adults living with
HIV and 83 randomly selected community controls all with ≤8 years of schooling. All
participants were assessed for non-verbal intelligence, verbal working memory and
executive functioning. The Major Depression Inventory and a quality of life measure
(RAND SF-36) were also administered.
Results: Using analysis of covariance, we found no statistically significant group
differences between adults living with HIV and community controls in all the
neurocognitive tests except for a marginal difference in the non-verbal intelligence test (F
(1, 158)=3.83, p=0.05). However, depressive scores of adults living with HIV were
significantly higher than those of controls (F (1, 158)=11.56, p<0.01). Also, quality of
life scores of adults living with HIV were significantly lower than those of controls (F (1,
158)=4.62, p=0.03). For the HIV-infected group, results from multivariable linear
regression analysis showed that increasing depressive scores were significantly
associated with poorer quality of life (β=-1.17, 95% CI -1.55 to -0.80; p<0.01).
Conclusion: Our findings suggest that adults of low-literacy levels living with HIV and
on antiretroviral medication at the Kenyan coast do not have significant cognitive deficits
compared with their uninfected counterparts. However, their mental health, compared
with that of HIV-uninfected adults, remains poorer and their quality of life may
deteriorate when HIV and depressive symptoms co-occur.