Tesfaye Markos, Kaestel Pernille, Olsen Mette Frahm, Girma Tsinuel, Yilma Daniel, Abdissa Alemseged, Ritz Christian, Prince Martin, Friis Henrik, Hanlon Charlotte
Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia.
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
Health Qual Life Outcomes. 2016 Mar 3;14:37. doi: 10.1186/s12955-016-0440-8.
Studies from high-income settings show that both food insecurity and common mental disorders (CMDs) are associated with lower quality of life among people living with HIV (PLHIV). However, there is limited research among PLHIV in sub-Saharan Africa. In this study we tested the hypothesis that food insecurity and CMDs would be associated with poorer quality of life of PLHIV in Ethiopia.
A cross-sectional study was carried out with 348 PLHIV who were initiating antiretroviral therapy recruited from two primary care centers and a tertiary Hospital in southwest Ethiopia. Food insecurity, CMD, and quality of life were measured using instruments adapted and validated in Ethiopia (Household Food Insecurity Access Scale, Kessler-6, and WHOQOL-HIV-BREF-ETH, respectively). Multiple linear regression analysis was used to identify factors associated with quality of life after adjusting for confounders.
The prevalence of severe household food insecurity among PLHIV was 38.7 %. After adjusting for confounders, severe food insecurity (β = -3.24, 95 % CI: -6.19; -0.29) and higher levels of CMD symptoms (β = -1.72 for each 1 point increase, 95 % CI: -1.94; -1.49) were associated with lower quality of life. Other factors associated with lower quality of life were advanced HIV disease (β = -3.80, 95 % CI: -6.18; -1.42), and being underweight (BMI = 17.0 - 18.5 kg/m(2)) (β = -3.45, 95 % CI: -6.18; -0.71). Owning more household assets was associated with higher quality of life (β = 0.99 for owning one more asset, 95 % CI: 0.09; 1.89).
Poor mental health and food insecurity are associated with lower quality of life in PLHIV. There is a need for longitudinal studies to elucidate the pathways linking CMD, food insecurity and quality of life.
高收入地区的研究表明，粮食不安全和常见精神障碍（CMD）都与艾滋病毒感染者（PLHIV）的生活质量较低有关。然而，撒哈拉以南非洲地区PLHIV中的相关研究有限。在本研究中，我们检验了以下假设：粮食不安全和CMD与埃塞俄比亚PLHIV较差的生活质量相关。
对从埃塞俄比亚西南部的两个初级保健中心和一家三级医院招募的348名开始接受抗逆转录病毒治疗的PLHIV进行了一项横断面研究。使用在埃塞俄比亚改编并验证的工具（分别为家庭粮食不安全获取量表、凯斯勒6项量表和WHOQOL-HIV-BREF-ETH）来测量粮食不安全、CMD和生活质量。在调整混杂因素后，使用多元线性回归分析来确定与生活质量相关的因素。
PLHIV中严重家庭粮食不安全的患病率为38.7%。在调整混杂因素后，严重粮食不安全（β = -3.24，95%CI：-6.19；-0.29）和较高水平的CMD症状（每增加1分β = -1.72，95%CI：-1.94；-1.49）与较低的生活质量相关。与较低生活质量相关的其他因素包括晚期艾滋病毒疾病（β = -3.80，95%CI：-6.18；-1.42）和体重过轻（BMI = 17.0 - 18.5 kg/m²）（β = -3.45，95%CI：-6.18；-0.71）。拥有更多家庭资产与较高的生活质量相关（每多拥有一项资产β = 0.99，95%CI：0.09；1.89）。
心理健康不佳和粮食不安全与PLHIV较低的生活质量相关。需要进行纵向研究来阐明连接CMD、粮食不安全和生活质量的途径。
