Attendance at an outpatient follow-up clinic by HIV-positive psychiatric patients initiated on ART as inpatients

South African Journal of Psychiatry

Field Value
Title Attendance at an outpatient follow-up clinic by HIV-positive psychiatric patients initiated on ART as inpatients
Creator Nel, Yvette M Jonsson, Gregory
Subject Psychiatry; HIV Attendance; psychiatry; ART Adherence
Description Background. Evidence suggests that the presence of mental illness may be associated with poorer adherence to antiretroviral therapy (ART). There is also a general understanding that patients initiated on ART as inpatients have poorer outcomes than those initiated as outpatients. Negative perceptions regarding future adherence may affect the clinical decision to initiate ART in hospitalised psychiatric patients. Attendance at clinic appointments is an indicator of medication adherence, and is easily measurable in a limited-resource setting. Objectives. The primary objective of this study was to examine the rate of attendance at the first clinic appointment post discharge from a period of psychiatric hospitalisation in HIV-positive psychiatric patients initiated on ART as inpatients. A secondary objective was to determine which factors, if any, were associated with clinic attendance. Methods. This study was a retrospective record review, conducted at the Luthando Neuropsychiatric HIV Clinic in Soweto, which is an integrated mental healthcare and ART clinic. Patients who were initiated on ART as psychiatric inpatients from 1 July 2009 to 31 December 2010, and subsequently discharged for outpatient follow-up at Luthando Clinic were included in the sample.  Results. There were 98 patients included in the analysis. The sample was predominantly female. The rate of attendance was 80%. The attendant and non-attendant groups were similar in terms of demographic and clinical data.  Significantly fewer non-attendant patients had disclosed their HIV status to their treatment supporter (p=0.01). Conclusion. Non-disclosure of HIV status needs to be further addressed in integrated psychiatric HIV treatment facilities in order to improve attendance. Female predominance in this setting should also be further investigated.
Publisher AOSIS
Contributor University of the Witwatersrand
Date 2015-08-01
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective review
Format application/pdf
Identifier 10.4102/sajpsychiatry.v21i3.695
Source South African Journal of Psychiatry; Vol 21, No 3 (2015); 5 pages 2078-6786 1608-9685
Language eng
Coverage — — In-patient, HIV-positive, psychiatric
Rights Copyright (c) 2015 Yvette M Nel, Gregory Jonsson