Neurosciences Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya.
Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Health Qual Life Outcomes. 2020 Jun 5;18(1):169. doi: 10.1186/s12955-020-01421-0.
Health-related quality of life (HRQoL) is an important metric of perceived wellbeing in people living with HIV/AIDS (PLWHA). However, research on HRQoL among PLWHA in sub-Saharan Africa is limited. This study investigates factors associated with HRQoL among PLWHA in Kilifi, coast of Kenya.
Between February and April 2018, 450 adults living with HIV and on combined antiretroviral therapy (cART) between 18 to 60 years were sequentially recruited from an HIV-specialized clinic. The Functional Assessment of HIV Infection (FAHI) questionnaire, previously adapted for assessing HRQoL in this setting, was slightly modified and administered to participants alongside other measures of sociodemographic, health and treatment characteristics in a face-to-face interview.
Linear regression analyses indicated that depressive symptoms, HIV-related stigma, non-disclosure of HIV status, living alone, clinic inaccessibility, and presence of any current opportunistic infection were significantly associated with lower HRQoL scores at both the FAHI overall and sub-scale level. Higher physician empathy, male sex, and higher body mass index were significantly associated with better HRQoL scores at both FAHI overall and sub-scale level. Age and longer duration on cART were significantly associated with better HRQoL only at the sub-scale level.
Interventions aimed at reducing depressive symptoms and HIV stigma, making HIV-related services more accessible, addressing opportunistic infections, strengthening social support systems, serostatus disclosure and put in place caring, respectful, and compassionate model of care are necessary to improve the HRQoL of PLWHA.
健康相关生活质量(HRQoL)是衡量艾滋病毒/艾滋病(PLWHA)患者生活幸福感的重要指标。然而,撒哈拉以南非洲地区 PLWHA 生活质量的研究有限。本研究调查了肯尼亚沿海基利菲地区 PLWHA 生活质量的相关因素。
2018 年 2 月至 4 月,从一家 HIV 专科诊所连续招募了 450 名年龄在 18 至 60 岁之间、正在接受联合抗逆转录病毒治疗(cART)的成年人。功能评估艾滋病毒感染量表(FAHI)问卷,之前已经适用于评估该环境下的 HRQoL,对参与者进行了稍作修改,并与社会人口统计学、健康和治疗特征的其他措施一起进行面对面访谈。
线性回归分析表明,抑郁症状、HIV 相关耻辱感、未披露 HIV 状况、独居、诊所难以到达,以及当前存在任何机会性感染与 FAHI 整体和子量表水平的较低 HRQoL 评分显著相关。医生同理心较高、男性和较高的体重指数与 FAHI 整体和子量表水平的较好 HRQoL 评分显著相关。年龄和更长的 cART 治疗时间仅与子量表水平的更好 HRQoL 相关。
旨在减少抑郁症状和 HIV 耻辱感、提高 HIV 相关服务的可及性、解决机会性感染、加强社会支持系统、血清学转阳状况披露和建立关爱、尊重和富有同情心的护理模式的干预措施对于改善 PLWHA 的 HRQoL 是必要的。