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Greater access to highly active antiretroviral treatment (HAART) has increased the survival of people living with HIV and AIDS (PLWHA), and health-related quality of life (HRQoL) has emerged as an important indicator of treatment outcomes. However, the success of HAART depends on consistent and optimum adherence. Various cross-sectional studies and few longitudinal studies identified the relationship between HRQoL and HAART; however their association over time is still unclear. The objective of this study is to investigate the relationship between HRQoL and adherence to HAART over time. 431 PLWHAs were followed for one year at 4-monthly intervals. A descriptive adherence self-report rating scale and WHOQOL-HIV BREF were administered to collect adherence and HRQoL data respectively. Optimum adherence was set at ≥95%. Significant differences (p<0.05) in the overall mean HRQoL scores of the HAART adherent (≥95%) and non-adherent (<95%) patients were observed amongst patients on HAART for the periods of 9-28 months, 49-64 months and 81-120 months. This study established a strong relationship between adherence to HAART and HRQoL over time. Adherence to HAART is still a challenge and needs to be addressed through appropriate interventions.   Key words: Highly active antiretroviral therapy, health-related quality of life, medication adherence, interrupted time-series analysis, South Africa.

Relationship between adherence and health-related quality of life among HIV-patients in South Africa: findings and implications