Abstract / Summary
Abstract Advances in antiretroviral therapy (ART) have increased survival among people living with HIV, resulting in a growing population of older adults who often face persistent psychological challenges. However, limited evidence exists on how in the face of these challenges, resilience may interact with psychiatric morbidity and HIV treatment adherence in African countries. This study therefore examined resilience among older adults living with HIV in Ibadan, Nigeria and its association with psychiatric morbidity and ART adherence. In this cross-sectional study, resilience, psychiatric morbidity and HIV treatment adherence were assessed among 400 older adults aged ≥ 50 years living with HIV. Resilience, depression, anxiety and sleep quality were measured using the 25-item Wagnild and Young resilience scale, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Antiretroviral medication adherence was self-reported for the prior 30-days. Associations between resilience levels, psychiatric morbidity, and medication adherence outcomes were investigated using multivariable logistic regression controlling for demographic and clinical factors. The mean age of participants was 58.2 ± 6.5 years. Low resilience was common, affecting approximately 89.7% of the cohort. The prevalence of psychiatric morbidity was 7.8% for depression, 6.0% for anxiety, and 15.2% for poor sleep quality. Overall, ART adherence was relatively high, with 85.5% of participants reporting adequate adherence. Higher resilience scores were associated with lower odds of depression (adjusted [aOR] = 0.958, 95% CI: 0.939–0.977), anxiety (aOR = 0.971, 95% CI: 0.950–0.993, p = 0.010) and an increased odds of at least 95% antiretroviral therapy adherence (aOR = 1.033, 95% CI: 1.008–1.058, p = 0.009). In this study of older adults living with HIV in Nigeria, the level of resilience was low but was protective for psychiatric morbidity and medication adherence. Promoting resilience may improve well-being among aging populations living with HIV.