Prevalence and predictors of depression and oral health related quality of life among patients living with HIV/AIDS in Nigeria: modifying influence of tobacco use

Abstract

Introduction: tobacco use remains a global health burden, and studies in developed countries have found a significantly higher  prevalence amongst persons living with HIV/AIDS (PLWHA) compared to the whole populace. PLWHA who smoke have a higher  predisposition to oral, respiratory and mental health illnesses, thereby worsening their Health-Related Quality of Life (HRQOL). We assessed the prevalence of self-reported depression and tobacco smoking, as well as their relationship with the oral health related quality  of life (OHRQOL) among PLWHA in Lagos, Nigeria.

Methods: using a descriptive design, 370 HIVpositive adults in Lagos State,  Nigeria were interviewed to obtain socio-demographic and HIV related clinical information as well as history of tobacco use. The Patient  Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder - 7 (GAD-7) and susceptibility to smoking cigarettes were also  determined. Bivariate and multivariate logistic regression analysis was done to identify factors significantly associated with self-reported depression and impacts on OHRQOL. Statistical significance was inferred at p values < 0.05.

Results: participants were mainly in the age  group of 31 - 40 years and were predominantly female (58.7%). The highest proportion of the participants (119; 32.1%) had been HIV  positive for ≥16 years; 26.6% had mild depression, 7.5% had Moderate/moderately severe depression while 3.4% had severe depression.  Majority of the respondents (54.3%) had low impacts on their OHRQOL while 22.7% had high impacts. There was a significant association  (p<0.05) between being male (female -aOR: 0.490; CI: 0.286-0.841), and smoking cigarettes (non-smokers -aOR: 0.206; CI: 0.090-0.472)  with having poor OHRQOL. There was also a significant association (p<0.05) between alcohol use (non-drinkers -aOR: 0.441; CI: 0.236- 0.823), and smoking cigarettes (non-smokers - aOR: 0.110; CI: 0.110-0.492) with depression amongst respondents. While those who drank alcohol, had a primary level of education, who do not use HAART, aged 21-30 years, and those who had been HIV positive for >16 years,  had increased odds of poor OHRQOL, the association was not ignificant.

Conclusion: our findings suggest are latively high level of  depression amongst PLWHA in Lagos, while almost a quarter had high impacts on their OHRQOL. Being male and combustible cigarette  smoking was significantly related with poor OHRQOL while smoking and alcohol consumption was significantly associated with depression. Electronic cigarette use was not associated with poorer OHRQOL, as observed amongst those using cigarettes, shisha and marijuana. Health promotion and regulatory policies should target smoking cessation amongst PLWHA.