Assessment of coping strategies among people living with hiv and aids on highly active antiretroviral therapy in Kinondoni municipality, Dar es Salaam

Abstract

Success of treatment with HAART, requires people with Hl V and AIDS to maintain nearly perfect adherence to prescribed regimen. Behaviour leading to effective utilization ofHAART and clinical outcome is partly determined by psychosocial factors Stress among PLHA is a psychosocial factor which impairs effort to maintain quality of life of PLHA on treatment. Coping strategies employed by PLHA on HAART in Tanzania are not known. The key objective of this study was to assess the coping strategies among PLHA and their influence on clinical outcome. In between the month of July and August 2008, a cross-sectional study was conducted at Mwananyamala Hospital and Sinza Health Centre. Data on demographic, medical, socio-economic characteristics and coping strategies adopted by PLHA on HAAR T were collected. Cross-tabulation and logistic regression analysis were run to ascertain the influence of coping strategies on clinical outcome. A total of 391 PLHA on HAART were interviewed, more than a half of the respondents 243 (62.1%) were females. Majority of PLHA were using adaptive coping strategies such as prayed for the healing power of Almighty God (religion), perceived Hl V as same as other chronic disease (positive reframing) and made jokes about HIV disease (humor) which predicted good clinical outcome. Conversely, very few patients adopted maladaptive coping strategies like denial and behavioral disengagement predicted poor clinical outcome. it is recommended to the Ministry of Health and Social Welfarelthe ational AIDS Control Program that: 1) Counselors need to be trained on promoting psychosocial behaviours among PLHA for good clinical progress; 2) develop partnership with religious leaders to manage psychological factors that are important in the management of mv and AIDS, and 3) there is a need to encourage and support entrepreneurial activities for PLHA that will boost their level of socio-economic status and keep them busy so as to promote positive reframing behavior.