Social grants for people living with HIV and on antiretroviral therapy in KwaZulu-Natal, South Africa: a longitudinal study
Keywordssocial grants, HIV patients, antiretroviral treatment, health status, KwaZulu-Natal, South Africa, longitudinal study.
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AbstractThe aim of this studywas to assess the predictorsof thereceipt of a disability grant (DG) status and the impact of theDGon health outcomesof HIV patients and on antiretroviral therapy (ART) in a longitudinal study over 20 months in KwaZulu-Natal, South Africa. Consecutive patients, 735 (29.8%males and 70.2% females), who attended three HIV clinics completed the assessments (with a structured questionnaire and medical file review) prior to antiretroviral initiation, 519 after 6 months, 557 after 12months and 499 after 20 months on ART. The results indicate that a large number ofHIV or ART patients were found to be in receipt of a DG,which declined significantly over the time of being on ART (from 52.3% at 6months onART to 9.8% at 20months on ART). At various stages, being in receipt of aDGwas found to be associated with not being employed, higher quality of life (QoL), older age, higher alcohol use score, noformal salary as householdincome and higher subjective health status in multivariable analyses. A significant number of patients lost their DG status over the assessment period, which was not found to be associated with major health outcomes (CD4 cell counts, adherence to ART and HIV symptoms). In a multiple regression generalized estimating equation model, not being in receipt of a DG, health-related QoL, lower HIV symptoms and lower depression scores were associated with CD4 counts. HIV patients who no longer qualify for the DG and yet do not haveadequate financial means to meet basic necessities should be put on a nutritional support programme.