艾滋病病毒/艾滋病感染者的健康相关生活质量：社会不平等和与疾病相关因素的作用。
Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors.
机构信息
College of Human Science, Department of Health Studies, University of South Africa (UNISA), Pretoria, South Africa.
Programme and Policy Section, United Nations World Food Programme, Addis Ababa, Ethiopia.
出版信息
Health Qual Life Outcomes. 2021 Feb 25;19(1):63. doi: 10.1186/s12955-021-01702-2.
BACKGROUND
Health-related quality of life (HRQoL) serves as a direct measure of individuals' health, life expectancy and the impact that the utilization of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV (PLHIV), and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia.
METHODS
A cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centers participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Global Physical Health (GPH) and Global Mental Health (GPH) summary scores were employed. GPH and GMH summary scores below 50 (the standardized mean score) were determined as poor HRQoL. Bivariate and multivariate logistic regression analyses were used to identify factors associated with GPH and GMH summary scores.
RESULTS
This study included 259 (66.4%) females and 131 (33.6%) males. The GPH summary scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a GPH summary score of below 50; the GMH summary scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has a GMH summary score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor GPH and poor GMH summary scores. Age below 25 years and being a member of Christian fellowship were inversely associated with poor GPH. The least wealth index score and CD4 count below 350 cells/mL were also associated with poor GMH.
CONCLUSION
Overall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLHIV. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximize PLHIVs' HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLHIV.
背景
健康相关生活质量（HRQoL）是个体健康、预期寿命以及医疗保健利用对生活质量影响的直接衡量标准。本研究旨在评估感染艾滋病毒（HIV）的人群（PLHIV）的 HRQoL，并确定其与埃塞俄比亚本尚古勒-古马兹州 HIV 感染者之间的社会不平等和临床决定因素之间的关联。
方法
2016 年 12 月至 2017 年 2 月期间进行了一项横断面研究；来自两家转诊医院和三家保健中心的 390 人参与了研究。采用患者报告结局测量信息系统全球健康量表（PROMIS Global 10）测量关键 HRQoL 领域。采用全球身体健康（GPH）和全球心理健康（GMH）综合评分。GPH 和 GMH 综合评分低于 50（标准化平均分数）被确定为 HRQoL 较差。采用单变量和多变量逻辑回归分析确定与 GPH 和 GMH 综合评分相关的因素。
结果
本研究包括 259 名（66.4%）女性和 131 名（33.6%）男性。GPH 综合评分范围为 16.2 至 67.7，平均 48.8（SD=8.9）。研究人群中约有 44.6%的 GPH 综合评分低于 50；GMH 综合评分范围为 28.4 至 67.6，平均 50.8（SD=8.1）。研究人群中约有 41.8%的 GMH 综合评分低于 50。失业、家庭粮食不安全以及与 HIV 相关的合并症与 GPH 和 GMH 综合评分均较差相关。年龄小于 25 岁和属于基督教团契与 GPH 评分较差呈负相关。最低财富指数评分和 CD4 计数低于 350 个细胞/毫升也与 GMH 评分较差相关。
结论
总体而言，社会经济不平等和与 HIV 相关的临床因素在改善 PLHIV 的 HRQoL 方面发挥着重要作用。这些决定因素中有许多是可以改变的风险因素。适当的策略可以改善慢性 HIV 护理的整体管理，最大限度地提高 PLHIV 的 HRQoL。此类策略需要采取全面的干预措施，包括改善 PLHIV 健康、福祉和生计的政策和方案。
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