***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Malnutrition hastens progression to Acquired Human Immunodeficiency Syndromes ( AIDS ) related illnesses ; undermines adherence and response to antiretroviral therapy ( ART ) in re source -poor setting s. However , nutritional status of people living with HIV ( PLHIV ) can be affected by various psychosocial factors which have not been well explored in Ethiopia . Therefore , the objective of this study was to determine psychosocial correlates of nutritional status among people living with HIV ( PLHIV ) on ART in Central zone of Tigray , Northern Ethiopia . Methods A matched case-control study design was conducted to assess psychosocial correlates of nutritional status among PLHIV on ART .  Data were collected by an interviewer-administered technique using structured pre-tested question naire , record review using a checklist and anthropometric measurements . Cases were selected by simple r and om sampling and controls purposively to match the selected cases . Conditional logistic regression was used to compute relevant associations by STATA version 12 . Results The psychosocial factors independently associated with malnutrition were ever consuming alcohol after starting ART [ AOR = 4.7 , 95 % CI : 1.8–12.3 ] , ever smoking cigarette after starting ART [ AOR = 7.6 , 95 % CI : 2.3–25.5 ] , depression [ AOR = 2.8 , 95 % CI : 1.3 , 6.1 ] , not adhering to ART [ AOR = 6.8,95 % CI : 2.0–23.0 ] and being in the second lowest wealth quintile [ AOR = 4.3,95 % CI : 1.1–17.7 ] . Conclusion Ever consuming alcohol and ever smoking cigarette after starting ART , depression , not adhering to ART and being in the second lowest wealth quintile were significantly associated with malnutrition . Therefore ; policies , strategies , and programs targeting people living with HIV should consider psychosocial factors that can impact nutritional status of people living with HIV enrolled on ART Background The devastating impact of AIDS in the world especially in sub-Saharan Africa has led to an unprecedented global effort to ensure access to antiretroviral ( ARV ) drugs . Given that medication-taking behavior can immensely affect an individual 's response ; ART adherence is now widely recognized as an ' Achilles heel ' for the successful outcome . The present study was undertaken to investigate the rate and predictors of adherence to antiretroviral therapy among HIV-infected persons in southwest Ethiopia . Methods The study was conducted in the antiretroviral therapy unit of Jimma University Specialized Hospital . A prospect i ve study was undertaken on a total of 400 HIV infected person . Data were collected using a pre-tested interviewer-administered structured question naire at first month ( M0 ) and third month ( M3 ) follow up visits . Results A total of 400 and 383 patients at baseline ( M0 ) and at follow up visit ( M3 ) respectively were interviewed . Self-reported dose adherence in the study area was 94.3 % . The rate considering the combined indicator ( dose , time and food ) was 75.7 % . Within a three month follow up period , dose adherence decreased by 2 % and overall adherence rate decreased by more than 3 % . Adherence was common in those patients who have a social support ( OR , 1.82 , 95%CI , 1.04 , 3.21 ) . Patients who were not depressed were two times more likely to be adherent than those who were depressed ( OR , 2.13 , 95%CI , 1.18 , 3.81 ) . However , at the follow up visit , social support ( OR , 2.42 , 95%CI , 1.29 , 4.55 ) and the use of memory aids ( OR , 3.29 , 95%CI , 1.44 , 7.51 ) were found to be independent predictors of adherence . The principal reasons reported for skipping doses in this study were simply forgetting , feeling sick or ill , being busy and running out of medication in more than 75 % of the cases . Conclusion The self reported adherence rate was high in the study area . The study showed that adherence is a dynamic process which changes overtime and can not reliably be predicted by a few patient characteristics that are assumed to vary with time . Adherence is a process , not a single event , and adherence support should be integrated into regular clinical follow up Health-related quality of life ( HRQoL ) is an important outcome measure among HIV-infected patients receiving combination antiretroviral therapy ( cART )  , but has not been studied extensively in re source -limited setting s. Insight in the predictors or correlates of poor HRQoL may be helpful to identify patients most in need of additional support and to design appropriate interventions . A cross-sectional study was conducted between September 2012 and April 2013 in 10 healthcare facilities in Addis Ababa , Ethiopia . Patients who were at least 6 months on cART were r and omly selected and individual patient data were retrieved from medical records .  HRQoL was measured by the WHOQoL-HIVBREF , depressive-symptoms by the Kessler-6 scale , and stigma by the Kalichman internalized AIDS-related stigma scale .  Multivariate linear regression analysis was carried-out to examine associations between HRQoL and the other variables . A total of 664 patients ( response-rate 95 % ) participated in the study . A higher level of depressive-symptoms was most strongly and consistently associated with a lower HRQoL , both in terms of the magnitude of the relationship and in the number of HRQoL domains associated with it . Also , a higher level of HIV-stigma was associated with a lower HRQoL except for the physical domain , while obtaining sufficient nutritious food and job opportunity were associated with a better HRQoL except for the spiritual and social domains , respectively . Demographics , clinical , and treatment characteristics yielded few significant associations with HRQoL. Our study findings suggest that interventions to improve HRQoL should focus on reducing depressive-symptoms and HIV-stigma , and on enhancing food security and job opportunity ABSTRACT Developing appropriate strategies to sustain optimal medication adherence among the increasing number of HIV-positive patients taking antiretroviral therapy ( ART ) in sub-Saharan Africa is a major challenge . The objective of this study was to determine patient , regimen , disease , patient-provider , and healthcare-related factors associated with adherence with ART over a one-year period , and assess the impact of adherence on treatment outcomes . We performed a prospect i ve , observational study among 246 patients who were initiated on ART in Ethiopia . Of 172 who completed follow-up , 130 ( 75.6 % ) had ≥95 % adherence . In the multivariate analyses , a higher baseline BMI ( OR , 1.2 ; 95 % CI 1.0 , 1.4 ) and use of reminder devices ( OR , 9.1 ; 95 % CI 2.0 , 41.6 ) remained positively associated with adherence , while a higher HIV symptom and adverse drug reaction distress score was an independent negative predictor of adherence ( OR , 0.90 ; 95 % CI 0.9 , 1.0 ) CD4 count increase was significantly higher in the adherent patients compared to non-adherent patients at 12 months ( 159 cells/µL [ interquartile range ( IQR ) , 72–324 cells/µL ] vs. 132 cells/µL [ IQR , 43–190 cells/µL ] ; p = 0.026 ) . Our findings indicate that interventions aim ed at improving adherence and thereby treatment outcomes in patients initiated on ART should promote the use of reminder devices , and monitor HIV symptoms and adverse reaction distress and nutritional status 
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Conclusions and Recommendation The pooled estimate prevalence of depression among PLWHIV was higher than that in the general population .
It is better to offer special attention to these population