Women’s mental health has an impact on the adequate adherence for the antiretroviral HIV therapy
HIV/AIDS is, at a global scale, the main cause of death among women on reproductive age. In Mexico, around 230 thousand people, including adults and children, live with HIV. The acronym HIV means Human Immunodeficiency Virus. It damages the immunological system by destroying white blood cells, and these cells are the ones that fight infections diseases. For that reason, a person with HIV is at a higher risk of contracting serious infections and cancers. AIDS is the acquired immunodeficiency syndrome and it is the final stage of HIV infection. Not all people with HIV develop AIDS.
The virus can infect anyone; it is propagated through semen, vaginal secretions, blood, and breast milk. Once the virus is contracted, it remains in the body for life. To this day, there is no cure for HIV but there are treatments that help people with HIV to stay healthy and live a normal life for many years. Generally, symptoms do not manifest immediately, for that reason it can be difficult to detect if someone has the virus. Years may pass until a person knows he/she has HIV.
During the first two to four weeks after contracting the virus, a fever, pain, or discomfort may manifest. These symptoms can go away by a week or they may not even show again. As time goes by, HIV cause AIDS; though, with the proper treatment on an opportunely time, AIDS may take longer to develop. Some signals of AIDS are: sores, throat pains, severe fungal infections, chronic pelvic inflammatory disease, severe recurrent infections, constant fatigue, dizziness and lightheadedness, headaches, a sudden weight loss, constantly getting bruises, diarrhea, fever, night sweats, swollen glands on the throat, armpit or groin, feeling a lack of air, bleeding on the mouth, nose, anus, or vagina, rashes, hand or feet numbness, a lack of muscular strength, among many others.
Antiretroviral therapy consists on the use of medication against HIV to treat the infection. Any person with HIV is encouraged to use the therapy, as it may help to have a longer healthier life, and it reduces the risk of the transmission of the virus. A study performed a systematic revision and a meta-analysis to determine the efficiency of the interventions of adherence to the therapy, focused on women.
The adherence to the therapy is defined as the capacity of a participant to follow the instructions and prescribed medication, including time and frequency. The measures of adherence can manifest as percentages, indicating the number of pills taken divided by the number of pills prescribed for a set time, or as a qualitative evaluation. All this is important because adherence is an important behavior to achieve the suppression of the viral load of the virus, the last step of the therapy.
On the meta-analysis of the 56 observational studies performed on a global scale that reported adherence by gender, the authors discovered that 62% of women achieved adherence, in comparison with the 67% of men. Additionally, it was discovered that factors as emotional distress, the stigma, and the negative impact of social relations can be intensified among women living with HIV, which can influence adherence.
The additional barrier that women face, as mental health, have a negative higher impact than that of men. This is due all of the challenges women have to go through, influencing on adherence. Future research focused on individual consulting that considers a cultural context, is necessary. To fulfill the regime of HIV treatment avoids the virus to multiply and thus avoiding the destruction of the immune system. The fact to take medication against HIV everyday reduced the risk of the virus transmission.
Reviewers: Brenda Giselle Alvarez Rodriguez (Public Health Research Unit), and Cassandra Saldaña Pineda (Knowledge Management Unit).
- Planned Parenthood Federation of America Inc.
- InfoSIDA – Departamento de Salud y Servicios Humanos de EE. UU.
- Article: “A Systematic Review and Meta-analysis of Antiretroviral Therapy (ART) Adherence Interventions for Women Living with HIV”. AIDS Behav (2018). https://doi.org/10.1007/s10461-018-2341-9