Préau Marie, Protopopescu Camélia, Spire Bruno, Sobel Alain, Dellamonica Pierre, Moatti Jean-Paul, Carrieri M Patrizia
National Health Institute (INSERM) U379/ Southeastern Health Regional Observatory (ORS-PACA), 23 rue Stanislas Torrents, 13006 Marseilles, France.
Drug Alcohol Depend. 2007 Jan 12;86(2-3):175-82. doi: 10.1016/j.drugalcdep.2006.06.012. Epub 2006 Aug 22.
This study aimed to determine factors associated with higher levels of health related quality of life (HRQL) among individuals HIV-infected through drug injection and to evaluate the impact of injecting drug status and opiate substitution treatment (OST) on HRQL.
Two hundred and forty-three patients, enrolled in the MANIF cohort of patients HIV-infected through IDUs, participated. They completed a self-administered questionnaire, which included an HRQL evaluation (SF-12) and socio-demographic/clinical characteristics at the 42-month visit. Injecting drug status, OST and experience of negative life events (NLE) were collected at any follow-up visit in order to reconstitute individual trajectories.
Among the 243 patients, 35% reported a normal mental HRQL and 37% a normal physical HRQL. Independent predictors of "normal" mental HRQL were social support from partner, being a former IDU, no experience of violence-related NLE and few self-reported HAART-related side effects. "Normal" physical HRQL was predicted by younger age, stable partner, being a former IDU (> or = 6 months), CD4 cell count > 500, no experience of financial-related NLE and few HAART self-reported side effects.
As HRQL has been found to have a prognostic value on the survival of HIV patients infected through drug injection, then providing more comprehensive care (for example by paying more attention to patients' experience of stressful events, meeting their needs in psychosocial support and better management of perceived toxicity) could globally improve treatment outcomes in this vulnerable population.
本研究旨在确定与通过药物注射感染艾滋病毒的个体中较高水平的健康相关生活质量（HRQL）相关的因素，并评估注射毒品状况和阿片类药物替代治疗（OST）对HRQL的影响。
参与了通过注射吸毒者感染艾滋病毒患者的MANIF队列研究的243名患者。他们在42个月的随访中完成了一份自我管理的问卷，其中包括HRQL评估（SF - 12）以及社会人口统计学/临床特征。在任何随访中收集注射毒品状况、OST和负面生活事件（NLE）的经历，以重建个体轨迹。
在243名患者中，35%报告精神HRQL正常，37%报告身体HRQL正常。“正常”精神HRQL的独立预测因素是来自伴侣的社会支持、曾经是注射吸毒者、没有与暴力相关的NLE经历以及很少有自我报告的与高效抗逆转录病毒治疗（HAART）相关的副作用。“正常”身体HRQL的预测因素是年龄较小、伴侣稳定、曾经是注射吸毒者（≥6个月）、CD4细胞计数>500、没有与经济相关的NLE经历以及很少有HAART自我报告的副作用。
由于已发现HRQL对通过药物注射感染艾滋病毒患者的生存具有预后价值，因此提供更全面的护理（例如更多地关注患者的压力事件经历、满足他们在心理社会支持方面的需求以及更好地管理感知到的毒性）可以全面改善这一弱势群体的治疗结果。
