Determinants of health-related quality of life in adults living with HIV in Vietnam

Abstract

Health-related quality of life (HRQL) is a good indicator to monitor and evaluate healthcare services for adults with HIV/AIDS. This study described HRQL of adults with HIV and its determinants, and compared it with HRQL for the general population. A cross-sectional study with a national multistage sampling of households with and without HIV-positive people was conducted in 2008. Six provinces were purposively selected to represent areas of the country and progressions of HIV epidemics. Households were sampled with probability-proportional-to-size, following the selection of rural and urban districts. A total of 820 HIV-positive and HIV-negative adults (mean age: 32.5; 38.7% female) were interviewed. Among 400 HIV-positive people, 52.3% had a history of injecting drugs, and 56.3% were at AIDS stage and receiving antiretroviral treatment (ART). HRQL was measured using the EuroQOL five-dimension questionnaire (EQ-5D). Multiple regression models were purposefully constructed to examine the determinants of HRQL. The EQ-5D index and visual analog scale (VAS) score in less advanced HIV people (0.90, 69.3) and AIDS patients (0.88, 65.2) were significantly lower than those of the general population (0.96, 81.6) (p<0.001). The frequency of reported problems across EQ-5D dimensions in the HIV population (2.4-30.9%) was significantly higher than in the general population (0.7-12.1%). Compared to ART patients, those at earlier HIV stages reported having problems at similar proportions across four HRQL dimensions, except pain/discomfort, where ART patients had a significantly higher proportion. Injecting drug users taking ART perceived lower HRQL score than non-injecting drug users. Multiple regression determined that joblessness (p<0.01) and inaccessibility to health services (p<0.05) were associated with lower HRQL. In addition, involvements in self-help groups significantly improved HRQL among HIV-positive participants (p<0.05). The findings highlight the need to improve the health service referral system and enhance psychological and social supports for patients in early stages of HIV infection in Vietnam.

Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam

“…Furthermore, the EQ-VAS (visual analogue scale) measures the self-rated health on a 20-cm vertical scale, with the endpoint ranges from 0 to 100 point, labeled ‘the worst health you can imagine” and ‘the best health you can imagine” [33]. A prior study suggested that the VAS score of 80 was equal to the average score of normal Vietnamese population [9]. Therefore, this threshold was chosen for optimal HRQOL.…”

“…By the end of 2015, over 17 million people living with HIV (PLWHs) worldwide were on ART, two million of whom initiated their treatment the same year [4]. ART helps PWLH to prolong virologic suppression, bolster their immune systems, decrease opportunistic infections, and therefore, lengthen their lifespan and improve their quality of life [5–9]. The patients have to strictly adhere to their regimes in order for the treatment to be successful and to prevent drug resistance [10].…”

Higher Quality of Life and Lower Depression for People on ART in Uganda as Compared to a Community Control Group

“…Typically studies report higher depression in those with HIV than without [28], [29], although ART is linked to reduced depression in PLWH [24]. Lower QOL is reported in those with HIV compared to a general population sample, for example comparing PLWH on ART to a general sample in Vietnam [30] and in Malawi [31]. These studies include either people on ART for a short duration or made no selection based on ART duration.…”

Willingness to pay for methadone maintenance treatment in Vietnamese epicentres of injection-drug-driven HIV infection

“…Interviewers first reviewed the adverse consequences of injection drug use (e.g. increased risk of HIV transmission, stigma and economic hardship) 3,7,21,22 and the delivery and benefits of MMT (e.g. effectiveness, cost-effectiveness and improved access to health-care services).…”