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埃塞俄比亚中部北谢瓦地区公立医院接受抗逆转录病毒治疗随访的HIV阳性女性的健康相关生活质量:一项横断面研究的证据

Health related quality of life of HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia: Evidence from a cross-sectional study.

作者信息

Girma Derara, Dejene Hiwot, Geleta Leta Adugna, Tesema Mengistu, Legesse Elsabeth, Nigussie Tadesse, Deriba Berhanu Senbeta, Geleta Tinsae Abeya, Sahlu Degemu, Waleligne Addisu, Debela Sisay Abebe, Awol Mukemil

机构信息

Department of Public Health, College of Health Science, Salale University, Ethiopia.

Department of Midwifery, College of Health Science, Salale University, Ethiopia.

出版信息

Heliyon. 2023 Jan 29;9(2):e13318. doi: 10.1016/j.heliyon.2023.e13318. eCollection 2023 Feb.

Abstract

BACKGROUND

Evidence revealed that there is a statistically significant gender difference in Health-related quality of life (HRQoL) among HIV-positive people on Antiretroviral therapy (ART). Consequently, HIV-positive women have low scores in all HRQoL domains than men. Despite this fact, previous studies in Ethiopia focused on general HIV-positive people and paid less attention to HIV-positive women. Therefore, this study was intended to measure HRQoL and associated factors among HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from February 01-April 30, 2022. Four hundred twenty-six women on ART were included using a systematic random sampling technique. Face-to-face interviews and medical record reviews were used to collect data. Both bivariable and multiple linear regressions were computed to identify the factors associated with HRQoL. A p-value <0.05 was used to assert statistically significant variables in multiple linear regression analysis.

RESULTS

The overall mean (SD) score of the HRQoL was 11.84 (2.44). And, 44.7% [95% CI: 40.3, 49.5] of the women have poor HRQoL. In multiple linear regression analysis, factors like depression (β = -0.35), Post-Traumatic Stress Disorder (PTSD) (β = -0.16), age (β = -0.07), rural residence (β = -0.52), and bedridden functional status (β = -1.02) were inversely associated with HRQoL. Oppositely, good treatment adherence (β = 0.46) was positively associated with overall HRQoL, keeping other factors constant.

CONCLUSION

This study reveals a high magnitude of poor HRQoL among HIV-positive women. Therefore, as HRQoL domains are comprehensive indicators of living status, healthcare service providers should be dedicated to screening and supporting HIV-positive women with poor HRQoL. Additionally, healthcare providers should also pay special attention to routine PTSD screening and management for HIV-positive women due to its detrimental effect on HRQoL.

摘要

背景

有证据表明,接受抗逆转录病毒治疗(ART)的HIV阳性患者在健康相关生活质量(HRQoL)方面存在统计学上显著的性别差异。因此,HIV阳性女性在所有HRQoL领域的得分均低于男性。尽管如此,埃塞俄比亚此前的研究主要关注一般HIV阳性人群,对HIV阳性女性关注较少。因此,本研究旨在测量埃塞俄比亚中部北谢瓦地区公立医院接受ART随访的HIV阳性女性的HRQoL及其相关因素。

方法

于2022年2月1日至4月30日进行了一项基于机构的横断面研究。采用系统随机抽样技术纳入了426名接受ART治疗的女性。通过面对面访谈和病历审查收集数据。采用双变量和多元线性回归分析来确定与HRQoL相关的因素。在多元线性回归分析中,p值<0.05用于确定具有统计学意义的变量。

结果

HRQoL的总体平均(标准差)得分为11.84(2.44)。并且,44.7%[95%置信区间:40.3,49.5]的女性HRQoL较差。在多元线性回归分析中,抑郁(β=-0.35)、创伤后应激障碍(PTSD)(β=-0.16)、年龄(β=-0.07)、农村居住(β=-0.52)和卧床功能状态(β=-1.02)等因素与HRQoL呈负相关。相反,在其他因素不变的情况下,良好的治疗依从性(β=0.46)与总体HRQoL呈正相关。

结论

本研究揭示了HIV阳性女性中HRQoL较差的比例较高。因此,由于HRQoL领域是生活状况的综合指标,医疗服务提供者应致力于筛查并支持HRQoL较差的HIV阳性女性。此外,由于PTSD对HRQoL有不利影响,医疗服务提供者还应特别关注对HIV阳性女性进行常规的PTSD筛查和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/418c/9898445/bb1f2bcb0f2f/gr1.jpg

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