Abstract
The emergence of a chronic medical illness such as Human Immune Deficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) may be the time when people turn to the Sacred through spirituality and religion. HIV is a chronic illness that requires strict adherence to medication regimens that may be influenced by spirituality/religion. This study was aimed at finding the association between spirituality/religion and adherence to highly active antiretroviral therapy (HAART) in adult HIV/AIDS patients. This is a cross-sectional descriptive study of 370 patients. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG) and visual analogue scale (VAS) tools. Spirituality was assessed using Functional Assessment of Chronic Illness Therapy-Spirituality Expanded (FACIT-Sp-Ex) scale, religiosity with Duke University Religion index (DUREL), and religious coping with Brief Religious Coping (RCOPE) scale. Adherence rates were 86.2 and 43.8% using AACTG and VAS tools, respectively. Statistical significant correlation was found between spirituality and adherence to HAART (r = 0.265; p = 0.00). Also, significant correlation was found between positive religious coping and adherence (r = 0.15, p = 0.003). Odds ratio indicated that female respondents were 1.6 times more likely to be adherent, compared with males. Similarly, every unit rise in spirituality score yielded a 1.3 times increased likelihood of adherence to HAART on multiple logistic regression of adherence to HAART with relevant predictors. Both spirituality and positive religious coping have positive influence on optimal adherence. Therefore, the training of health care personnel to assess and provide spiritual care and involvement of chaplains/religious leaders is advocated for improved adherence.
Highlights
Spirituality has long been linked with health and wellbeing and may be a central issue for patients at the end of life or those dealing with a chronic illness such as Human Immune Deficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) [1, 2]
* 5 Nagelkerke’s R2; ** 5 Hosmer Lemeshow test; *** 5 considered poor owing to low N R2. This facility-based study among 370 adult respondents living with HIV/AIDS was aimed at assessing the possible relationship between Spirituality/Religion and adherence to highly active antiretroviral therapy (HAART)
The level of spirituality, religious involvement, and coping especially among female HIV/AIDS patients significantly influenced optimal adherence to HAART. This relationship may not be directly causal owing to the roles of many other determinant factors, it provides better understanding of how assessment of spirituality may be useful for the improvement of HAART adherence
Summary
Spirituality has long been linked with health and wellbeing and may be a central issue for patients at the end of life or those dealing with a chronic illness such as Human Immune Deficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) [1, 2]. Spirituality, broadly defined as that which provides meaning and purpose to life, is a person’s belief in a power apart from their own existence, while religion on the other hand pertains to the outward practice of a spiritual understanding and/or the framework for a system of beliefs, values, codes of conduct, and rituals. Both play crucial roles in guiding the decisions of people with HIV/AIDS about taking antiretroviral treatment [1,2,3]. When illness strikes, it affects the person in totality (biologic, psychological, social, and spiritual aspects)
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