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Reproductive health and lifestyle factors associated with health-related quality of life among perinatally HIV-infected adolescents in Uganda
Background
With increased survival of perinatally HIV - infected adolescents due to antiretroviral therapy (ART), the focus of HIV care has shifted to health-related quality of life (HRQoL) as a measure of disease progression, effects of ART co-morbidity and prognosis. We assessed factors associated with better HRQoL in perinatally HIV -infected adolescents in Uganda by determining the associations between sexual and reproductive health (SRH) or lifestyle experiences on HRQoL.
Methods
In a cross-sectional study, data on SRH, lifestyle experiences, socio demographic factors, communication with parents on sexuality and satisfaction of SRH services in ART clinics were collected from 614 HIV perinatally infected adolescents aged 10β19 using an interviewer-administered survey questionnaire. HRQoL data were collected using the Medical Outcomes Study HIV Health Survey instrument (MOS-HIV). Factors associated with better HRQoL were analysed using multiple logistic regression.
Results
The mean age was 16.2βΒ±β2.1 years, 362 (58.8 %) were females and 210 (34.2 %) were sexually active. Adolescents on ART were twice likely to present with better physical health (AORβ=β2.07, 95 % CI: 1.24β3.46) and four times more likely to present with better mental health (AORβ=β3.9, 95 % CI: 2.22β6.92) than those who were not on ART. There were no statistically significant associations between SRH (ever had sex, ever been pregnant, condom use, contraceptive use) or life style factors and physical health or mental health. Those with secondary or tertiary education were more likely to present with a better mental health (AORβ=β5.3, 95 % CI: 1.86β15.41) compared those who had attained primary or no education. Participants who desired to have a child in future more likely (AOR 1.7, 95 % CI: 1.05β3.00) to present with a better mental health. Lack of communication with guardians on sexuality (AORβ=β0.6, 95 % CI: 0.40β0.89), or dissatisfaction with SRH services (AOR 0.34, 95 % CI: 0.18β0.62) were associated with poorer mental health.
Conclusion
Among perinatally HIV-infected adolescents in Uganda, being on ART was associated with better physical and mental health while lack of communication with guardians on sexuality or dissatisfaction with SRH services was associated with poor mental health. Adolescents with pregnancy intentions were more likely to have a better mental health
Obesity and Reproductive Performance in Women
Obesity and overweight are not only problem of developed nations but also an increasing problem in developing countries with health consequences. Studies have highlighted the link between obesity, infertility and adverse reproductive health outcome. Obesity contributes majorly to two most common medical risks in pregnancy: diabetes and hypertension. It is associated with increased risk of large-for-gestational age and hypertensive disorders, including preeclampsia, which may be associated with low birth weight. Combination of factors viz individual lifestyle, environmental and genetic play role in obesity. Weight loss has demonstrated to improve fertility in obese women through recovery of spontaneous ovulation, and improved response to ovarian stimulation in infertility treatment. Therefore, weight management interventions, should be considered for overweight and obese infertile women (Afr. J. Reprod. Health 2010; 14[3]: 143-151).Key words: Obesity, reproductive health, fertility