Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain.
Working Group on HIV Treatments (gTt-HIV), Barcelona, Spain.
PLoS One. 2024 May 7;19(5):e0301335. doi: 10.1371/journal.pone.0301335. eCollection 2024.
Current antiretroviral therapies have increased the life expectancy of people living with HIV (PLHIV). There is, however, limited evidence regarding the health-related quality of life (HRQoL) and living conditions of older people living with HIV (OPLHIV) in Spain.
We implemented a self-administered online questionnaire to identify sex differences in HRQoL and poverty risk among Spanish OPLHIV (PLHIV ≥50 years). Participants were contacted through non-governmental organisations. We used the standardised WHOQoL-HIV BREF questionnaire and the Europe 2020 guidelines to estimate HRQoL and poverty risk respectively. The statistical analysis included multivariable generalised linear models with potential confounding variables and robust estimates.
The study included 247 OPLHIV (192 men and 55 women). On the WHOQoL-HIV BREF questionnaire, men scored higher on 84% of items and in all six domains. Women had significantly lower HRQoL in five domains: physical health (β: -1.5; 95% CI: -2.5, -0.5; p: 0.002), psychological health (β: -1.0; 95% CI: -1.9, -0.1; p: 0.036), level of independence (β: -1.1; 95% CI: -1.9, -0.2; p: 0.019), environmental health (β: -1.1; 95% CI: -1.8, -0.3; p: 0.008), and spirituality/personal beliefs (β: -1.4; 95% CI: -2.5, -0.3; p: 0.012). No statistical differences were found in the domain of social relations. Poverty risk was considerable for both men (30%) and women (53%), but women were significantly more likely to experience it (OR: 2.9; 95% CI: 1.3, 6.5; p: 0.009).
The aging of PLHIV is a public health concern. Our findings indicate that HRQoL and poverty risk among Spanish OPLHIV differ significantly by sex. Spain should, therefore, implement specific policies and interventions to address OPLHIV needs. The strategies must place a high priority on the reduction of sex inequalities in HRQoL and the enhancement of the structural conditions in which OPLHIV live.
目前的抗逆转录病毒疗法已经提高了艾滋病毒感染者（PLHIV）的预期寿命。然而，关于西班牙老年艾滋病毒感染者（OPLHIV）的健康相关生活质量（HRQoL）和生活状况，证据有限。
我们实施了一项自我管理的在线问卷，以确定西班牙老年艾滋病毒感染者（PLHIV≥50 岁）的 HRQoL 和贫困风险的性别差异。通过非政府组织联系参与者。我们分别使用标准化的世卫组织艾滋病毒生活质量量表 - 简要版（WHOQoL-HIV BREF）问卷和欧洲 2020 年指导方针来估计 HRQoL 和贫困风险。统计分析包括多变量广义线性模型，其中包括潜在的混杂变量和稳健估计。
研究包括 247 名 OPLHIV（192 名男性和 55 名女性）。在 WHOQoL-HIV BREF 问卷上，男性在 84%的项目和所有六个领域的得分都更高。女性在五个领域的 HRQoL 显著较低：身体健康（β：-1.5；95%置信区间：-2.5，-0.5；p：0.002），心理健康（β：-1.0；95%置信区间：-1.9，-0.1；p：0.036），独立性水平（β：-1.1；95%置信区间：-1.9，-0.2；p：0.019），环境卫生（β：-1.1；95%置信区间：-1.8，-0.3；p：0.008）和精神信仰/个人信仰（β：-1.4；95%置信区间：-2.5，-0.3；p：0.012）。社会关系领域没有发现统计学差异。男性（30%）和女性（53%）的贫困风险都相当大，但女性发生贫困的可能性明显更高（OR：2.9；95%置信区间：1.3，6.5；p：0.009）。
PLHIV 的老龄化是一个公共卫生问题。我们的研究结果表明，西班牙老年艾滋病毒感染者的 HRQoL 和贫困风险存在显著的性别差异。因此，西班牙应实施具体政策和干预措施，以满足老年艾滋病毒感染者的需求。这些策略必须高度重视减少 HRQoL 方面的性别不平等，并加强老年艾滋病毒感染者的生活条件。
