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O'Connor C, Leyritana K, Doyle AM, Lewis JJ, Salvaña EM. Changes in Adherence and Viral Load Suppression Among People with HIV in Manila: Outcomes of the Philippines Connect for Life Study. AIDS Behav 2024; 28:837-853. [PMID: 37794284 DOI: 10.1007/s10461-023-04190-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
The Philippines HIV epidemic is among the fastest growing globally. Infections among men who have sex with men are rising at an alarming rate, necessitating targeted evidence-based interventions to retain people living with HIV in care, support adherence, and reach viral suppression. We conducted a 48-week prospective cohort study of 462 participants in which we provided a mobile health (mHealth) adherence support intervention using the Connect for Life platform. We observed an improvement in adherence, with the proportion of participants taking more than 95% of their antiretroviral therapy (ART) doses increasing from 78.6% at baseline to 90.3% at 48 weeks. Among treatment experienced participants, adherence improved significantly (McNemar's test = 21.88, P < 0.001). Viral load suppression did not change, with 92.6% suppression at baseline and 92.0% at 48 weeks. Illicit drug use was associated with reduced adherence (aOR = 0.56, 95%CI 0.31-1.00, P = 0.05) and being on second-line therapy was associated with poor viral load suppression (aOR = 0.33, 95%CI 0.14-0.78, P = 0.01). Quality of life improved following ART initiation, from a mean of 84.6 points (of a possible 120) at baseline to 91.01 at 48 weeks. Due to technical issues, fidelity to the intended intervention was low, with 22.1% (102/462) of participants receiving any voice calls and most others receiving a scaled-back SMS intervention. The mHealth intervention did not have any observed effect on adherence or on viral load suppression. While evidence of effectiveness of mHealth adherence interventions is mixed, these platforms should continue to be explored as part of differentiated treatment support services.
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Affiliation(s)
- Cara O'Connor
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines.
- The London School of Hygiene and Tropical Medicine, London, UK.
- Anova Health Institute, 12 Sherborne Ave. Parktown, Johannesburg, South Africa.
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines
| | - Aoife M Doyle
- MRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - James J Lewis
- Y Lab, the Public Services Innovation Lab for Wales, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Edsel Maurice Salvaña
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, Ermita, Manila, Philippines
- Section of Infectious Disease, Department of Medicine, University of the Philippines College of Medicine, University of the Philippines Manila, Ermita, Manila, Philippines
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Torres TS, Jesus JS, Arabe D, Guaraldo L, Lessa FS, Facchinetti LD, Estrela R, Veloso VG, Grinsztejn B, Cardoso SW. Frailty and health-related quality of life among older people living with HIV pre- and post-COVID-19 pandemic onset: A cross-sectional study. Braz J Infect Dis 2024; 28:103723. [PMID: 38369295 PMCID: PMC10904252 DOI: 10.1016/j.bjid.2024.103723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/30/2023] [Accepted: 01/24/2024] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION Antiretroviral therapy increased the survival and life expectancy of People living With HIV (PWH). Frailty-related syndromes among older PWH (aged 50+ years) may affect their Health-related Quality of Life (HQoL). Additionally, the COVID-19 pandemic has impacted health-related outcomes. This study aimed to estimate the prevalence of frailty and pre-frailty among older PWH, and to explore associations of HQoL with the study assessment period and frailty status. METHODS Cross-sectional study conducted pre- (23-Mar-2019 to 5-Mar-2020) and post-COVID-19 pandemic onset (23-Jun-2021 to 5-May-2022), among older PWH at INI-Fiocruz, the largest cohort of PWH in Rio de Janeiro, Brazil. We measured frailty using Fried assessment, consisting of five domains: unintentional weight loss; self-reported exhaustion, weakness, slow walking speed, low physical activity. HQoL was assessed using the ACTG SF-21, which contains 21 questions divided into 8 domains. We used Chi-Square test, Fisher's exact test, Kruskal-Wallis and ranksum test for comparisons. RESULTS We included 250 older PWH: 109 (43.6 %) pre- and 141 (56.4 %) post-COVID-19 pandemic onset. Median age was 60-years (IQR: 55‒64). Most self-identified as cisgender men 152 (60.8 %), Pardo/Black 146 (58.4 %), with completed secondary education or less 181 (72.7 %) and low income 132 (52.8 %). Overall, prevalence of frailty and pre-frailty were 9.2 % (95 % CI: 8.1‒10.3) and 61.6 % (95 % CI: 54.0‒69.2). Prevalence of frailty in the pre- and pos-COVID-19 pandemic periods were 7.3 % and 10.6 % (p = 0.66). HQoL scores were lower among participants with frailty compared to those with non-frailty and pre-frailty in all eight domains, and among those included in the post-COVID-19 compared to pre-COVID-19 period for four domains. CONCLUSIONS We observed low prevalence of frailty, but high prevalence of pre-frailty among older PWH. Frailty status did not differ according to the COVID-19 assessment period. Assessment of frailty and HQoL should be incorporated in clinical practice for older PWH. Programs to reverse or prevent frailty should be implemented within the public health system.
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Affiliation(s)
- Thiago S Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil.
| | - Jovanice S Jesus
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Daniel Arabe
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Lusiele Guaraldo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Flavia Serrao Lessa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Lívia Dumont Facchinetti
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rita Estrela
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Sandra W Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
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Dietrich JJ, Jonas K, Cheyip M, Appollis TM, Ariyo O, Beauclair R, Lombard C, Gray GE, Mathews C. Examining the Relationship Between Psychosocial Factors with Knowledge of HIV-Positive Status and Antiretroviral Therapy Exposure Among Adolescent Girls and Young Women Living with HIV in South Africa. AIDS Behav 2023; 27:231-244. [PMID: 35841462 PMCID: PMC9841063 DOI: 10.1007/s10461-022-03759-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 01/24/2023]
Abstract
Adolescent girls and young women (AGYW) living with HIV have poor antiretroviral therapy (ART) outcomes. We examined the relationship between psychosocial factors with knowledge of HIV-positive status and antiretroviral therapy exposure among AGYW living with HIV in South Africa. Participants 15-24 years responded to a survey including socio-demographics, psychosocial factors, and HIV testing. Blood was collected to determine HIV status and ART exposure. Multivariable analyses were conducted using R. Of 568 participants with HIV, 356 had knowledge of their HIV-positive status. Social support from family [aOR 1.14 (95% CI 1.04-1.24)] or from a special person [aOR 1.12 (95% CI 1.02-1.23)] was associated with knowledge of HIV-positive status. Resilience [aOR 1.05 (95% CI 1.01-1.08)] was the only psychosocial factor associated with a higher odds of ART exposure. Social support and resilience may increase knowledge of HIV-positive status and ART exposure among South African AGYW.
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Affiliation(s)
- Janan J. Dietrich
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa,Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kim Jonas
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa,Adolescent Health Research Unit, Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Mireille Cheyip
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Tracy McClinton Appollis
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa,Adolescent Health Research Unit, Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Roxanne Beauclair
- The South African Department of Science and Technology/National Research Foundation (DST-NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Bellville, South Africa,Division of Epidemiology and Biostatistics, Department of Global Health, University of Stellenbosch, Bellville, South Africa
| | - Glenda E. Gray
- Office of the President, South African Medical Research Council, Bellville, South Africa
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa,Adolescent Health Research Unit, Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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4
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Mokgethi NO, Christofides N, Machisa M, Akpomiemie G, Lalla-Edward S. Quality of life and associated factors among people receiving second-line anti-retroviral therapy in Johannesburg, South Africa. BMC Infect Dis 2022; 22:456. [PMID: 35550020 PMCID: PMC9103409 DOI: 10.1186/s12879-022-07429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background Studies which examine quality of life (QOL) provide important insights that are needed to understand the impacts of HIV/AIDS anti-retroviral treatment (ART), comorbid conditions and other factors on the daily activities of people living with HIV/AIDS (PLH). This study aimed to determine the inter-relationships between clinical factors, behavioural, socio-demographic variables and QOL among PLH. Methods The secondary analysis used data collected from 293 people living with HIV/AIDS (PLH) receiving second-line ART in Johannesburg in a clinical trial which evaluated the non-inferiority of ritonavir-boosted darunavir (DRV/r 400/100 mg) compared to ritonavir-boosted lopinavir (LPV/r) over a 48 week-period. Physical functioning, cognitive and mental QOL were measured using the Aids Clinical Trial Group questionnaire. Exploratory factor analyses were used to examine the structure, the relationships between and the construct validity of QOL items. Structural equation models which tested the a priori-hypothesised inter-relationships between QOL and other variables were estimated and goodness of fit of the models to the data was assessed. Results Patients on darunavir presented with lower pill burden. Older patients and women were more likely to report lower QOL scores. Pill burden mediated the effects of age, sex and treatment regimen on physical functioning QOL and adverse effects; the effects of age, sex, treatment regimen and adverse effects on cognitive QOL; and the effects of sex on mental QOL. Conclusion QOL among PLH is associated with socio-demographic and clinical factors. Therefore, QOL could be enhanced by considering PLH characteristics, clinical factors such as regimen side-effects profile, management of comorbid conditions and mitigating risks such as potential adverse drug-to-drug interactions among patients on ART. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07429-9.
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Affiliation(s)
- Nomcebo Oratile Mokgethi
- Epidemiology and Biostatistics, WHO, Bloemfontein, Free State, South Africa. .,School of Public Health, Wits University, Johannesburg, South Africa. .,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | | | - Mercilene Machisa
- School of Public Health, Wits University, Johannesburg, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Godspower Akpomiemie
- School of Public Health, Wits University, Johannesburg, South Africa.,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Lalla-Edward
- School of Public Health, Wits University, Johannesburg, South Africa.,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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5
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Chow NK, Harun SN, Khan AH. Health-related quality of life and its association with sociodemographic, economic, health status and lifestyles among HIV-positive patients in northern Malaysia. AIDS Care 2021; 34:936-941. [PMID: 34543113 DOI: 10.1080/09540121.2021.1981220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sociodemographic status and medical problems were widely reported as the major factors in people living with HIV (PLHIV) with lower health-related quality of life (HRQoL). However, lifestyles and cultural changes are rarely studied. A multicentred cross-sectional study was conducted among 137 virally suppressed PLHIV on antiretroviral therapy (ART) in northern Malaysia by face-to-face interviews and World Health Organization Quality of Life (WHOQOL)-BREF questionnaire. It was to explore their health and socioeconomic status, lifestyles, and associations with different HRQoL domains. The result of multiple linear regression showed that smoking was a predominant risk factor of lower physical (beta coefficient (β): -5.82, 95% confidence interval (CI): -9.97 to -1.66; p = 0.006), social (β: -8.76, 95% CI: -15.12 to -2.40; p = 0.007), and environmental domain scores (β: -10.25, 95% CI: -15.21 to -5.30; p < 0.001). Poor physical health also associated with unemployment (p < 0.001) and adverse drug reaction (p = 0.015). Ethnicity was a significant factor of psychological (p = 0.007) and environment domain score (p = 0.009). HRQoL of PLHIV is strongly associated with their lifestyles and societal class. Mandatory lifestyle screening, behavioural interventions and re-employment assistance should be implemented on all PLHIV.
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Affiliation(s)
- Ngah Kuan Chow
- Department of Pharmacy, Hospital Sultanah Maliha, Langkawi, Kedah, Malaysia
| | - Sabariah Noor Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Opollo V, Sun X, Lando R, Miyahara S, Torres TS, Hosseinipour MC, Bisson GP, Kumwenda J, Gupta A, Nyirenda M, Katende K, Suryavanshi N, Beulah F, Shah NS. The effect of TB treatment on health-related quality of life for people with advanced HIV. Int J Tuberc Lung Dis 2021; 24:910-915. [PMID: 33156757 DOI: 10.5588/ijtld.19.0716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Study A5274 was an open-label trial of people with HIV (PLHIV) with CD4 cell count <50 cells/µL who were randomized to empirical TB treatment vs. isoniazid preventive therapy (IPT) in addition to antiretroviral therapy (ART). We evaluated health-related quality of life (HRQoL) by study arm, changes over time, and association with sociodemographic and clinical factors.METHODS: Participants aged >13 years were enrolled from outpatient clinics in 10 countries. HRQoL was assessed at Weeks 0, 8, 24 and 96 with questions about daily activity, hospital or emergency room visits, and general health status. We used logistic regression to examine HRQoL by arm and association with sociodemographic and clinical factors.RESULTS: Among 850 participants (424 empiric arm, 426 IPT arm), HRQoL improved over time with no difference between arms. At baseline and Week 24, participants with WHO Stage 3 or 4 events, or those who had Grade 3 or 4 signs/symptoms, were significantly more likely to report poor HRQoL using the composite of four HRQoL measures.CONCLUSION: HRQoL improved substantially in both arms during the study period. These findings show that ART, TB screening, and IPT can not only reduce mortality, but also improve HRQoL in PLHIV with advanced disease.
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Affiliation(s)
- V Opollo
- Kenya Medical Research Institute, HIV-Research Branch, Kisumu, Kenya
| | - X Sun
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - R Lando
- Kenya Medical Research Institute, HIV-Research Branch, Kisumu, Kenya
| | - S Miyahara
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - T S Torres
- Instituto Nacional de Infectologia Evandro Chagas (INI-FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - M C Hosseinipour
- University of North Carolina School of Medicine, Chapel Hill, NC, USA, University of North Carolina Project, Lilongwe, Malawi
| | - G P Bisson
- Perlman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - A Gupta
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - K Katende
- Joint Clinical Research Centre Clinical Research Site, Kampala, Uganda
| | - N Suryavanshi
- Byramjee Jeejeebhoy Government Medical College Clinical Trials Unit, Pune, India
| | - F Beulah
- YR Gaitonde Centre for AIDS Research and Education, Chennai Antiviral Research and Treatment Clinical Research Site, Chennai, India
| | - N S Shah
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Torres TS, Harrison LJ, La Rosa AM, Zheng L, Cardoso SW, Ulaya G, Akoojee N, Kadam D, Collier AC, Hughes MD. Poor quality of life and incomplete self-reported adherence predict second-line ART virological failure in resource-limited settings. AIDS Care 2021; 33:1340-1349. [PMID: 33487029 DOI: 10.1080/09540121.2021.1874275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We evaluated health-related quality of life (QoL) and self-reported incomplete adherence as predictors of early second-line antiretroviral (ART) virological failure (VF). ACTG A5273 study participants completed the ACTG SF-21 measure which has 8 QoL domains. We used exact logistic regression to assess the association of QoL at baseline and week 4 with early VF adjusted for self-reported adherence. Of 500 individuals (51% women, median age 39 years) in this analysis, 79% and 75% self-reported complete adherence (no missing doses in the past month) at weeks 4 and 24, respectively. Early VF was experienced by 7% and more common among those who self-reported incomplete adherence. Participants with low week 4 QoL scores had higher rates of early VF than participants with high scores. After adjusting for self-reported adherence at week 4, VL and CD4 at baseline, cognitive functioning, pain and mental health domains were significantly associated with subsequent early VF. In this post-hoc analysis, poorer QoL adds to self-reported incomplete adherence after 4 weeks of second-line ART in predicting VF at week 24. Evaluation is needed to assess whether individuals with poorer QoL might be targeted for greater support to reduce risk of VF.Trial registration: ClinicalTrials.gov identifier: NCT01352715.
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Affiliation(s)
- Thiago S Torres
- LapClin-AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-FIOCRUZ), Rio de Janeiro, Brazil.,Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Linda J Harrison
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Lu Zheng
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sandra W Cardoso
- LapClin-AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-FIOCRUZ), Rio de Janeiro, Brazil
| | | | | | - Dileep Kadam
- Byramjee-Jeejeebhoy Medical College, Pune, Maharashtra, India
| | - Ann C Collier
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Michael D Hughes
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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- LapClin-AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-FIOCRUZ), Rio de Janeiro, Brazil
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Sari PI, Martawinarti RTSN, Lataima NS, Berhimpong VM. The Quality of Life of Patients with HIV/AIDS Undergoing Antiretroviral Therapy: A Systematic Review. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i3.16978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Quality of Life (QoL) is one of the most important things for a patient with HIV/AIDS. Good QoL will improve the adherence to treatment, especially antiretroviral therapy. The purpose of this study was to explore about the quality of life of the patients with HIV/AIDS undergoing antiretroviral therapy.Methods: The data was collected through a literature review from electronic databases such as Scopus, ProQuest, Google Scholar and Springerlink journal. The keywords were "quality of life", "HIV/AIDS", "quality of life of patients with HIV/AIDS" or "quality of life and HIV/AIDS and antiretroviral therapy".Results: The researcher obtained 15 articles based on the inclusion criteria. Several research articles that were analyzed showed that the Quality of Life of HIV/AIDS patients undergoing antiretroviral therapy was not all good. This is caused by the side-effects of using antiretroviral therapy and the side-effects that were physical, psychological, social and environmental.Conclusion: The impact of the side effects of antiretroviral therapy has caused the clients with HIV/AIDS to choose other therapies such as ART replacement therapy to improve the quality of life for patients with HIV/AIDS.
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9
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Gruszczyńska E, Rzeszutek M. Trajectories of Health-Related Quality of Life and Perceived Social Support Among People Living With HIV Undergoing Antiretroviral Treatment: Does Gender Matter? Front Psychol 2019; 10:1664. [PMID: 31396129 PMCID: PMC6664262 DOI: 10.3389/fpsyg.2019.01664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022] Open
Abstract
The study examined the trajectories of health-related quality of life (HRQoL) and perceived social support (PSS) among people living with HIV (PLWH), with a special focus on gender differences. The participants included 252 PLWH (18% female) undergoing antiretroviral therapy. HRQoL (WHO Quality of Life-BREF; WHOQOL Group, 1998) and PSS (Berlin Social Support Scales; Schulz and Schwarzer, 2003) were measured three times at six-month intervals. Using a univariate approach, three trajectories of HRQoL and four trajectories of PSS were identified. Gender and relationship status were significant covariates for PSS only, with overrepresentation of single women in the increasing trajectory. The dual trajectory approach revealed a match in the decrease of HRQoL and PSS, but only for 31% of the sample. In fact, decreasing PSS co-occurred with increasing as well as stable HRQoL. There was no significant gender effect in this regard. Although a clear correspondence for decreasing trajectories exists, the findings also highlight a discrepancy between HRQoL and PSS changes that are unrelated to gender.
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Affiliation(s)
- Ewa Gruszczyńska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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10
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Fumaz CR, Larrañaga-Eguilegor M, Mayordomo-López S, Gómez-Martínez S, González-García M, Ornellas A, Fuster Ruiz de Apodaca MJ, Remor E, Ballester-Arnal R. Health-related quality of life of people living with HIV infection in Spain: a gender perspective. AIDS Care 2019; 31:1509-1517. [PMID: 30917676 DOI: 10.1080/09540121.2019.1597959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Studies exploring gender differences in health-related quality of life (HRQOL) of people living with HIV/AIDS (PLWHA) are scarce and contradictory. This study evaluated gender differences in HRQOL of 744 PLWHA with median (IQR) age 44 (37-48) years and HIV infection diagnosed 12 (5-20) years earlier. Results showed important differences between genders (p < .05). Better male physical health was related to being employed, not having economic worries, not receiving psychological support, not having injected drugs in past, low negative mood HIV-related, low HIV illness representation and internalized stigma, and high body image satisfaction and health behavior. For women, variables were fewer years since HIV diagnosis and low enacted stigma-personal experience of rejection. Mentally, variables in men were being employed, not having injected drugs, having a stable partner, high health behavior, use of problem-solving coping, personal autonomy and personal meaning. In women, better mental health was related to high CD4 cells, self-esteem and body image satisfaction, and negative mood HIV-related. Men and women coincided in absence of past opportunistic infections being related to better physical and mental health, and absence of side effects for physical health and low HIV-related stress and HIV illness representation for mental health. Our results highlight the need for detailed study of gender differences that identify the bio-psycho-socio inequalities that affect HRQOL.
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Affiliation(s)
- Carmina R Fumaz
- HIV Unit, Germans Trias i Pujol University Hospital - Lluita contra la Sida Foundation , Barcelona , Spain.,Facultad de Medicina - Universitat Autònoma de Barcelona , Barcelona , Spain
| | | | | | - Sandra Gómez-Martínez
- Facultad de Ciencias de la Salud - Universitat Jaume I de Castelló , Castelló de la Plana , Spain
| | - Marian González-García
- HIV Unit, Germans Trias i Pujol University Hospital - Lluita contra la Sida Foundation , Barcelona , Spain
| | - Arelly Ornellas
- HIV Unit, Germans Trias i Pujol University Hospital - Lluita contra la Sida Foundation , Barcelona , Spain
| | | | - Eduardo Remor
- Facultad de Psicología, Universidad Autónoma de Madrid , Madrid , Spain
| | - Rafael Ballester-Arnal
- Facultad de Ciencias de la Salud - Universitat Jaume I de Castelló , Castelló de la Plana , Spain
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11
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Kagee A, Coetzee B, Toit SD, Loades ME. Psychosocial predictors of quality of life among South Africa adolescents receiving antiretroviral therapy. Qual Life Res 2018; 28:57-65. [PMID: 30244360 DOI: 10.1007/s11136-018-2010-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE 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). METHODS Using a cross-sectional survey design, we studied 134 South African adolescents receiving an ART at community clinics. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- A Kagee
- Department of Psychology, Stellenbosch University, Matieland, Private Bag X1, Stellenbosch, South Africa.
| | - B Coetzee
- Department of Psychology, Stellenbosch University, Matieland, Private Bag X1, Stellenbosch, South Africa
| | - S Du Toit
- Department of Psychology, Stellenbosch University, Matieland, Private Bag X1, Stellenbosch, South Africa
| | - M E Loades
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK
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Rzeszutek M, Gruszczyńska E. Consistency of health-related quality of life among people living with HIV: Latent statetrait analysis. Health Qual Life Outcomes 2018; 16:101. [PMID: 29793544 PMCID: PMC5968481 DOI: 10.1186/s12955-018-0929-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/08/2018] [Indexed: 01/20/2023] Open
Abstract
Background The aim of this longitudinal study was to examine the consistency of health-related quality of life (HRQoL) among people living with HIV (PLWH) by breaking down the variance of repeated HRQoL measures into trait, state, and method components and to test the stability of HRQoL over time. In addition, we wanted to examine whether HRQoL trait components are related to personality traits, while controlling for selected socio-medical variables. Methods Three assessments were performed with a six-month lag on each assessment. Each participant filled out a World Health Organization (WHO) Quality of Life-BREF to assess HRQoL and a NEO-FFI to measure Big Five personality traits. Overall, 82 participants out of 141 (58.2% of the initial sample) participated in all the assessments. Results The HRQoL among PLWH represented a stable trait to a somewhat greater extent than a situational variability, although the proportions were domain and time variant. More specifically, psychological domain appeared to be the most consistent, whereas social domain appeared to be the most prone to situational influences. The trait component of HRQoL was positively related to being in a relationship, being employed, and being extraverted, and negatively related to neuroticism, which altogether explained 26% of the trait variance. Conclusions HRQoL among PLWH is rather distinct from personality and socio-medical data, which indicates its uniqueness in a clinical practise. Thus, there is a need for a more comprehensive assessment of HRQoL among this patient group to capture an additional source of variance in this important theoretical construct.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Ewa Gruszczyńska
- Faculty of Psychology, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815, Warsaw, Poland
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