“The relationship between ART non-adherence and the quality of life, psychological distress and coping strategies of persons living with HIV/AIDS and their families in Tripoli, Libya”

Abstract

Non-adherence to antiretroviral therapy (ART) increases the risk of adverse medical, psychological, and socioeconomic outcomes for people living with HIV/AIDS. In Libya, limited research has examined the psychosocial factors associated with ART adherence and quality of life (QoL). This study investigated the relationships between ART adherence status, QoL (Q-LES-Q), psychological distress, coping strategies, and perceived social support among individuals living with HIV/AIDS in Tripoli, Libya. A quantitative cross-sectional correlational design was used. Data were collected from 118 participants receiving treatment at the Libyan National Centre for Disease Control, Tripoli Medical Centre, and Tripoli Central Hospital. Structured questionnaires assessed demographic characteristics, QoL, ART adherence, psychological distress, and coping strategies. Data were analysed using SPSS (version 25) and ethical standards were strictly maintained. Of the 118 participants, 103 (87.3%) were adherent to ART and 15 (12.7%) were non-adherent (12 males and 3 females). The sample was predominantly male (70%) and Arabic-speaking (93%). 58.5% of participants indicated the father as head of the household. Most adherent participants reported receiving social support from family and friends, while a smaller proportion reported limited or no support. Participants experienced moderate psychological distress, with stress (M = 10.73, SD = 4.57) and depression (M = 9.49, SD = 4.80), while anxiety showed relatively higher severity (M = 8.04, SD = 3.80). Emotion-focused coping strategies, particularly acceptance and religious coping, were most frequently used. QoL was highest in family and social domains and lowest in sexual functioning and leisure activities. QoL was negatively associated with stress (r = –.46), anxiety (r = –.54), depression (r = –.60), and maladaptive coping methods particularly substance use (r = –.31) and behavioural disengagement (r = –.21). In contrast, QoL was positively associated with adaptive coping strategies such as active coping, positive reframing, self-distraction, humour, acceptance, and emotional support. The final regression model explained 47% of the variance in QoL. Although the study title refers to families, data on family influence were obtained indirectly through participants’ reports of family relationships and perceived support.