Household Decision-Making Power and the Mental Health and Well-Being of Women Initiating Antiretroviral Treatment in Oromia, Ethiopia

Citation

Parcesepe, Angela M.; Tymejczyk, Olga; Remien, Robert H.; Gadisa, Tsigereda; Kulkarni, Sarah Gorrell; Hoffman, Susie; Melaku, Zenebe; Elul, Batya; & Nash, Denis (2018). Household Decision-Making Power and the Mental Health and Well-Being of Women Initiating Antiretroviral Treatment in Oromia, Ethiopia. AIDS Care, 30(2), 211-218. PMCID: PMC5748326

Abstract

Low decision-making power (DMP) has been associated with HIV seropositivity among women in sub-Saharan Africa. As treatment accessibility and life expectancy for HIV-positive individuals increase, greater attention to the mental health and well-being of HIV-positive women is needed. This study examined whether low DMP was associated with psychological distress, social support or health-related quality of life (HRQoL) among women initiating ART. The sample included 722 women aged 18 or older initiating ART during 2012-2013 at six HIV clinics in Oromia, Ethiopia. DMP was assessed with five questions about household resource control and decision-making. Psychological distress was assessed with the Kessler Psychological Distress Scale (K10). HRQoL was assessed with the overall subscale of the HIV/AIDS-Targeted Quality of Life instrument. Multivariable logistic regression analyses controlled for age, education, and location (urban/rural). Most respondents (63%) reported high DMP, followed by medium (27%) and low (10%) DMP. More than half (57%) reported psychological distress. Compared to medium DMP, low DMP among married or cohabitating women was associated with greater odds of low social support (aOR: 1.9 [1.3, 2.9]; high DMP among women not in a relationship was associated with greater odds of low social support (aOR: 4.4 [2.4, 8.1]) and psychological distress (aOR: 1.7 [1.1, 2.6]). Interventions to reduce psychological distress among women initiating ART should consider the familial context, as high DMP among women not in a relationship was associated with psychological distress. High DMP may indicate weak social ties and fewer material resources, particularly among women not in a relationship.

URL

http://dx.doi.org/10.1080/09540121.2017.1360998

Reference Type

Journal Article

Year Published

2018

Journal Title

AIDS Care

Author(s)

Parcesepe, Angela M.
Tymejczyk, Olga
Remien, Robert H.
Gadisa, Tsigereda
Kulkarni, Sarah Gorrell
Hoffman, Susie
Melaku, Zenebe
Elul, Batya
Nash, Denis

PMCID

PMC5748326

ORCiD

Parcesepe - 0000-0002-4321-125x