Developing countries need better antiretroviral drugs

Perceptions of lipodystrophy among PLHIV after 10 years of antiretroviral therapy in Senegal

Nearly one-third of people living with HIV (PLHIV) and taking HAART develop lipodystrophy in Africa. This article aims to describe how they perceive these disorders and the determinants of these perceptions. It is based on a qualitative study using interviews conducted with 20 patients with clinical lipodystrophy in Dakar, Senegal. Not all of the interviewees complained, though some had clearly visible lipodystrophy. The hypertrophic form seems better tolerated when perceived as overweight, a sign of excess wealth. Atrophic forms sometimes go unnoticed in lean people, but others experience it as stigma, avoid appearing in public, and express significant suffering, especially when symptoms jeopardize their social status. Healthcare systems should take better account of lipodystrophy and its psychosocial effects because they weaken adherence and reduce patients' quality of life.