Assessment of the Quality of Life of Young People on Anti-Retroviral Therapy: A Rural - Urban Comparison in North Central Nigeria

Introduction: Despite the advances made in HIV prevention, treatment and care, HIV/AIDS is still a leading cause of morbidity/mortality among young people in Sub-Saharan Africa. In order to meet the UNAIDS target of ending HIV/AIDS epidemics worldwide, concerted efforts are needed to stop the transmission, ensure viral suppression and enable people living with HIV to lead normal lives. Given the unique position that young people on ART occupy in the continuum of care, the quality of their lives have a direct bearing on the efforts towards the achievement epidemic control.  Objective: This study was meant to assess on the one hand, and then compare, on the other hand, the quality of life of young people on ART in rural and urban facilities in Nasarawa State, north central Nigeria.  Method: This study was a comparative cross sectional descriptive study carried out in Dalhatu Araf Specialist Hospital, Lafia and General Hospital Obi, as the urban and rural health facilities respectively. A multistage sampling technique was used to select 354 respondents. Respondents were young people aged 10 years – 24 years and caregivers of young people aged 10 years – 17 years. Quantitative data was collected through a pretested interviewer-administered questionnaire. Qualitative data was collected through focus group discussions (FGDs). Data Analysis: Quantitative data was collated and analysed with IBM Statistical Package for Social Sciences (SPSS) version 23. Quantitative variables were described using mean and frequency while Chi-square test and Fisher’s Exact test were used to compare categorical variables. Logistic regression was used to determine the predictors of quality of life. At 95% Confidence interval, a p-value ≤ 0.05 was considered significant. Qualitative data was transcribed and analysed using NVIVO version 11.  Results: The mean age of the respondents was 16 (±3.2) in the urban facility and 18 (±4.3) in the rural facility. About 54% of young people in the urban facility had good quality of life ratings compared to 46% of those in the rural facility. This difference between the two facilities was statistically significant. Predictors of good QoL in the urban facility were the level of education (AOR – 2.12, 95% CI – 1.13-3.95, p=0.019) and the ART regimen (AOR – 0.36, 95% CI – 0.14-0.95, p=0.040).  Conclusion: There was a significant disparity in the quality of life ratings among young persons on ART between the urban and rural facilities. The study also showed that level of education and ART regimen type were predictors of good quality of life.