Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors

Abstract

Background: Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilization of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV/AIDS (PLWHA), and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia.Methods: A cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centers participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Physical Health Summary (PHS) and Mental Health Summary (MHS) scores were employed. PHS and MHS scores below 50 (the standardized mean score) were determined to be poor and above 50 to be good. Bivariate and multivariate logistic regression analyses were used to identify factors associated with PHS and MHS scores. Results: This study included 259 (66.4%) females and 131 (33.6%) males. The PHS scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a PHS score of below 50; the MHS scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has an MHS score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor PHS and poor MHS scores. Age below 25 years and being a member of Christian fellowship were inversely associated with poor PHS. The least wealth index score and CD4 count below 350 cells/mL were also associated with poor MHS. Conclusion: Overall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLWHA. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximize PLWHAs’ HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLWHA.

Determinants of Health-Related Quality of Life (HrQoL) of People living with HIV Based on Sexual Orientation

“…Studies have also suggested several factors associated with poor QoL of PLHIV in general, such as low level of educational attainment, unemployment status, perception of being ill, and dissatisfaction with sexual activity. 7,10–12 The experiences of family food insecurity, polypharmacy use, the advanced state of HIV infection and psychiatric comorbidities are also factors associated with poor QoL among PLHIV. 11–13 The use of illicit drugs which negatively influence the physical and mental well-being of PLHIV was also found to cause poor QoL among them.…”

Understanding the quality of life of people living with HIV in rural and urban areas in Indonesia

“…Human Immunodeficiency Virus (HIV) infection has been a major global public health issue for about four decades. It has a range of impacts on the life of people living with it, including affecting their health, well-being or quality of life (QoL) [1,2]. Previous studies have reported various factors that support or negatively impact the QoL of people living with HIV (PLHIV) in many settings.…”