Quality of Life Research

, Volume 28, Issue 1, pp 57–65 | Cite as

Psychosocial predictors of quality of life among South Africa adolescents receiving antiretroviral therapy

  • A. KageeEmail author
  • B. Coetzee
  • S. Du Toit
  • M. E. Loades



Minimal research has been conducted to understand how fatigue influences quality of life (QOL) among adolescents living with HIV. The purpose of the study was to examine the relationship between fatigue, sleep disturbance, depression, anxiety, pain and QOL among adolescents receiving antiretroviral therapy (ART).


Using a cross-sectional survey design, we studied 134 South African adolescents receiving an ART at community clinics.


Participants in general reported low levels of fatigue, insomnia, distress and pain and non-problematic levels of QOL. In the regression model, the linear combination of these variables explained 49% of the variance in QOL, a large effect size. Insomnia, anxiety, and depression significantly predicted QOL but surprisingly fatigue and pain did not.


Many members of the sample experienced non-clinical levels of sleep disturbance, fatigue and psychosocial distress. Similarly, QOL was within the normal range. These findings are surprising as the commonly held assumption is that adolescents living with HIV, especially those of poorer socio-economic backgrounds, would experience lower QOL than the norm. Even though scores on the instruments measuring these variables fell in the non-clinical range, they were still robustly predictive of poor QOL. Future research may address the relationship between self-reported adherence and QOL, possibly by examining the role of viral load as a mediating variable. Further research may also focus on non-adherent adolescents to understand the ways in which fatigue and other factors such as school functioning and social interaction influence QOL.


Quality of life Adolescents Fatigue Antiretroviral therapy 



We would like to acknowledge Stellenbosch Universities Sub-Committee A, as well as the University of Bath’s Faculty of Humanities and Social Sciences & Department of Psychology for funding this research. The funding was supported by Universiteit Stellenbosch (ZA) and University of Bath.


Dr. Loades is funded by the National Institute for Health Research (Doctoral Research Fellowship, DRF-2016-09-021). This report is independent research. The views expressed in this publication are those of the authors(s) and not necessarily those of the NHS, The National Institute for Health Research or the Department of Health. Dr. Kagee is funded by the National Research Foundation.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of PsychologyStellenbosch UniversityStellenboschSouth Africa
  2. 2.Department of PsychologyUniversity of BathBathUK

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