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中国新诊断出 HIV 感染者的健康相关生活质量变化及其决定因素:一项为期 1 年的随访研究。

Changes and determinants of health-related quality of life among people newly diagnosed with HIV in China: a 1-year follow-up study.

机构信息

Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China.

Hunan Provincial Center for Disease Prevention and Control, Changsha, Hunan, People's Republic of China.

出版信息

Qual Life Res. 2019 Jan;28(1):35-46. doi: 10.1007/s11136-018-1998-x. Epub 2018 Sep 11.

Abstract

PURPOSE

This study aimed to investigate changes in health-related quality of life (HRQoL) among people newly diagnosed with HIV and to identify factors associated with HRQoL.

METHODS

Newly diagnosed HIV-positive individuals were consecutively recruited and assessed at baseline and 1-year follow-up after diagnosis. HRQoL was measured through the physical health summary score (PHS) and mental health summary score (MHS) derived from the Medical Outcomes Study HIV Health Survey. Socio-demographic, clinical, and psychological information was also collected at both times. Generalized estimating equations were applied to explore factors associated with HRQoL in 1 year.

RESULTS

A total of 410 participants were included. After 1 year, significant increases were observed for both the mean PHS score (53.5-55.0; p = 0.009) and the mean MHS score (44.2-49.0; p < 0.001). Older age (p = 0.024), rural household registration (p = 0.031), HIV-related symptoms (p < 0.001), and depression (p = 0.014) were negatively associated with PHS. Additionally, the negative association between stress and PHS increased over time (β = - 0.07 for the baseline; β = - 0.18 for the 12-month follow-up; p < 0.001). HIV-related symptoms, depression, lower social support, and higher levels of stress (all p < 0.001) were negatively associated with MHS. Additionally, the negative relationship between stress and MHS was stronger among participants who were asymptomatic (p = 0.015).

CONCLUSION

A relatively lower HRQoL among HIV-infected people shortly after HIV diagnosis and an increase in HRQoL among people 1 year after HIV diagnosis were observed. Additional attention should be paid to individuals of older age, from rural areas, with HIV-related symptoms, with depression, with high levels of stress, and with a lack of social support.

摘要

目的

本研究旨在调查新诊断出 HIV 的人群的健康相关生活质量(HRQoL)变化,并确定与 HRQoL 相关的因素。

方法

连续招募新诊断出 HIV 阳性的个体,并在诊断后 1 年进行基线和随访评估。HRQoL 通过来自医疗结局研究 HIV 健康调查的身体健康综合评分(PHS)和心理健康综合评分(MHS)进行测量。在这两个时间点还收集了社会人口统计学、临床和心理信息。应用广义估计方程来探讨 1 年内与 HRQoL 相关的因素。

结果

共纳入 410 名参与者。1 年后,PHS 评分的均值(53.5-55.0;p=0.009)和 MHS 评分的均值(44.2-49.0;p<0.001)均显著增加。年龄较大(p=0.024)、农村户口(p=0.031)、HIV 相关症状(p<0.001)和抑郁(p=0.014)与 PHS 呈负相关。此外,压力与 PHS 之间的负相关随时间推移而增加(基线时为-0.07;12 个月随访时为-0.18;p<0.001)。HIV 相关症状、抑郁、较低的社会支持和较高的压力(均 p<0.001)与 MHS 呈负相关。此外,无症状参与者中压力与 MHS 之间的负相关更强(p=0.015)。

结论

在 HIV 诊断后不久,HIV 感染者的 HRQoL 相对较低,而在 HIV 诊断 1 年后,HRQoL 有所提高。应特别关注年龄较大、来自农村地区、有 HIV 相关症状、抑郁、压力水平较高和缺乏社会支持的个体。

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