HIV-related symptoms and management in HIV and antiretroviral therapy patients in KwaZulu-Natal, South Africa: A longitudinal study

Abstract

Aim: The study aimed to determine the prevalence, predictors, and self-reportedmanagement of HIV- or ARV-related symptoms among HIVpatients prior to antiretroviral therapy (ART) and over three time points while receivingARTinKwaZulu-Natal, SouthAfrica.

Method: A total of 735 consecutive patients (29.8% male and 70.2% female) who attended three HIV clinics completed assessments prior to ARV initiation, 519 after 6 months, 557 after 12months, and 499 after 20months on ART.

Results: The HIV patients reported an average of 7.5 symptoms (prior to ART), 1.2 symptomsafter 6months on ART, 0.3 symptomsafter 12months onART, and 0.2 symptoms after 20months onARTon the day of the interview, with a higher symptom frequency amongst patients whowere not employed, had lowerCD4cell counts, experienced internalised stigma, and used alcohol. The most common symptoms or conditions identified by the self-report included tuberculosis, diarrhoea, headaches, rash, nausea and vomiting, pain, neuropathy, lack of appetite, cough, and chills. Overall, the participants reported medications as the most frequently occurring  management strategy, with the second being spiritual, and the third being complementary or traditional treatments. The use of all other management strategies decreased over the four different assessment periods from prior to ART to 20 months on ART.

Conclusion: This study found a high symptom burden among HIV patients, which significantly decreased with progression on antiretroviral treatment. Several symptoms that persisted over time and several sociodemographic factors were identified that can guide symptom management. The utilisation of different symptom management strategies (medical, spiritual, complementary, and traditional) should be taken into consideration in HIV treatment.

Keywords: HIV symptoms, management strategies, antiretroviral therapy, longitudinal study