Quality of life in people living with HIV in Romania and Spain

Abstract

Background Health-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as HIV. The aim of the study was to examine and compare the health-related quality of life of people living with HIV in Romania and Spain, compared to the general populations of each country. Methods A cross-sectional survey was conducted among adults (≥ 18 years) attending for HIV care in Romania and Spain from October 2019 to March 2020. The survey included two validated HRQoL instruments: a generic instrument, EQ-5D-5L, and an HIV-specific instrument, PozQoL, and questions on socio-demographics, HIV-related characteristics, physical and mental health conditions, and substance use. Multivariable linear regression was used to determine factors associated with HRQoL. Results 570 people living with HIV responded (170 in Romania and 400 in Spain). The median age was 31 (18–67) in Romania and 52 (19–83) in Spain. Anxiety/depression symptoms were frequently reported by people with HIV (Romania: 50% vs 30% in the Romanian population; Spain: 38% vs 15% in Spanish population). Spain reported higher mean EQ-5Dutility scores than Romania (0.88 and 0.85, respectively) but identical PozQoL scores (3.5, on a scale of 0–5). In both countries, health concerns were highlighted as a key issue for people with HIV. In multivariable analysis, two factors were consistently associated with worse HRQoL in people with HIV: bad or very bad self-rated health status and presence of a mental health condition. In Romania, being gay/bisexual and being disabled/unemployed were associated with worse HRQoL. Whereas in Spain, older age and financial insecurity were significant predictors. Conclusions Our results indicated a good HRQoL for people living with HIV in Romania and Spain; however, worse HRQoL profiles were characterized by health concerns, poor self-rated health status, and the presence of mental health conditions. This study highlights the importance of monitoring HRQoL in people living with HIV due to the chronic nature of the disease. In this highly-treatment experienced group, disparities were found, particularly highlighting mental health as an area which needs more attention to improve the well-being of people living with HIV.

Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China

“…Previous studies have reported that HIV infection-related health impairments, including opportunistic infections, tumors, and malnutrition will not only reduce the quality of life of PLWHA but are also be affected by factors such as sex, age, economic status, marital status, educational level, CD4 + T cell count, and viral load ( 19 – 21 ). Available evidence reveals that anemia is quite common in PLWHA and is significantly associated with an increased risk of premature death ( 22 ).…”

Determinants of Depressive Symptoms in People Living with HIV: Findings from a Population-Based Study with a Gender Perspective

“…The success of antiretroviral therapy (ART) has lessened the clinical complications of HIV infection and increased the survival rate of PLWH, with the infection now considered a chronic disease in those countries where treatment is accessible [ 4 , 5 ]. Nevertheless, previous research indicated that PLWH have a worse health-related quality of life (HRQoL) than the general population [ 6 , 7 , 8 ]. Most of these studies considered HRQoL to be a multidimensional construct comprising factors such as physical, emotional, cognitive, and social functioning [ 6 , 7 ].…”

“…Nevertheless, previous research indicated that PLWH have a worse health-related quality of life (HRQoL) than the general population [ 6 , 7 , 8 ]. Most of these studies considered HRQoL to be a multidimensional construct comprising factors such as physical, emotional, cognitive, and social functioning [ 6 , 7 ]. Using validated instruments, they found worse HRQoL in PLWH in all the domains, particularly anxiety and depression, but also poor self-rated health status, than in people without HIV [ 6 , 7 ].…”

“…Most of these studies considered HRQoL to be a multidimensional construct comprising factors such as physical, emotional, cognitive, and social functioning [ 6 , 7 ]. Using validated instruments, they found worse HRQoL in PLWH in all the domains, particularly anxiety and depression, but also poor self-rated health status, than in people without HIV [ 6 , 7 ]. Insight into HRQoL is crucial if we are to understand the effects of HIV as a chronic disease and address the unmet needs of this population.…”

“…Insight into HRQoL is crucial if we are to understand the effects of HIV as a chronic disease and address the unmet needs of this population. However, few studies on HRQoL in PLWH have been carried out in the Spanish population, and samples are often non-representative [ 5 , 7 , 8 , 9 ].…”