Kumar Mithilesh, Murmu Nisha, Kujur Anit, Singh Shashi, Kumar Dewesh, Sagar Vidya
Community Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND.
Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS) Bhubaneswar, Bhubaneswar, IND.
Cureus. 2025 Jul 24;17(7):e88640. doi: 10.7759/cureus.88640. eCollection 2025 Jul.
Background AIDS, a potentially life-threatening disease caused by a retrovirus known as human immunodeficiency virus (HIV), has evolved from a mysterious illness to a global pandemic, affecting tens of millions of people. HIV/AIDS poses an increasing threat to the health of the population and causes further socioeconomic loss for people, communities and governments in many countries and drastically affects the quality and standard of life. Very few studies have used the World Health Organization Quality of Life HIV Brief Scale (WHOQOL-HIV BREF) instrument in people living with HIV and AIDS (PLWHA). The study aims to assess the quality of life (QOL) and economic burden of PLWHA and to determine various factors affecting their QOL. Methods The study was an institution-based cross-sectional study at an Anti-Retroviral Therapy Centre of a tertiary care hospital in the state of Jharkhand in India from June 2018 to November 2020. The study population consists of HIV/AIDS patients aged 18 years or older and who had been diagnosed as HIV positive and were on antiretroviral therapy (ART) for more than a month. Systematic random sampling was used to recruit 216 patients for this study. Data collected using the semi-structured questionnaire, WHOQOL-100 and WHOQOLHIV-BREF for assessing QOL and a self-designed, semi-structured and pretested proforma was used to assess the economic burden of PLWHA. The data were analysed by using the IBM Statistical Package for Social Science (SPSS) version 20.0 (IBM Corp, Armonk, NY, USA). Frequency tables were generated to see the distribution of variables. Student's t-distribution test was performed to assess the association between the mean score of QOL and dichotomous variables. One-way analysis of variance (ANOVA) was used for the variables with multiple categories. Correlation and multiple linear regression were implemented to see the association between economic burden and QOL. For all statistical analyses, a p-value <0.05 was considered significant. Results The mean age (±standard deviation (SD)) of 216 patients was found to be 40.48 (±11.87) years. In this study, participants reported a QOL score mean (±SD) of 55.48 (±8.006) for the physical domain, 64.87 (±6.920) for the psychological domain, 54.95 (±5.308) for the level of independence domain, 60.67 (±5.586) for the social relationship domain, 67.98 (±3.940) for the environmental domain and 49.42 (±5.202) for the spiritual/religious/personal beliefs (SRPB) domain. The total QOL score was found to be 57.79 (±3.248). The total mean economic burden was assessed to be INR 36,182.94 (±5606.98) per month. The study showed a significant association between the independent variables - total medical costs (p-value=0.022), loss of wages (p-value=0.005) and total economic burden (p-value =0.004) - and the total QOL scores. Conclusion Economic burden plays an important part in affecting the lives of people with HIV/AIDS. There is a need for financial intervention and rehabilitation programs catering to the needs of PLWHA, which will not only give them a sense of security but also lead them to have a community where they will feel welcome and be satisfied with their life.
背景 艾滋病是一种由人类免疫缺陷病毒（HIV）这种逆转录病毒引起的潜在威胁生命的疾病，已从一种神秘疾病演变成全球大流行，影响着数千万人。艾滋病毒/艾滋病对人群健康构成的威胁日益增加，给许多国家的个人、社区和政府造成了进一步的社会经济损失，并严重影响生活质量和生活水平。很少有研究在艾滋病毒和艾滋病感染者（PLWHA）中使用世界卫生组织生活质量艾滋病毒简表（WHOQOL-HIV BREF）工具。本研究旨在评估艾滋病毒和艾滋病感染者的生活质量（QOL）和经济负担，并确定影响其生活质量的各种因素。方法 本研究是一项基于机构的横断面研究，于2018年6月至2020年11月在印度恰尔肯德邦一家三级护理医院的抗逆转录病毒治疗中心进行。研究人群包括18岁及以上、被诊断为艾滋病毒阳性且接受抗逆转录病毒治疗（ART）超过一个月的艾滋病毒/艾滋病患者。采用系统随机抽样方法招募了216名患者参与本研究。使用半结构化问卷、WHOQOL-100和WHOQOLHIV-BREF收集数据以评估生活质量，并使用自行设计、半结构化且经过预测试的表格来评估艾滋病毒和艾滋病感染者的经济负担。数据使用IBM社会科学统计软件包（SPSS）20.0版（IBM公司，美国纽约州阿蒙克）进行分析。生成频率表以查看变量的分布情况。进行学生t分布检验以评估生活质量平均得分与二分变量之间的关联。对具有多个类别的变量使用单因素方差分析（ANOVA）方法。实施相关性分析和多元线性回归以查看经济负担与生活质量之间的关联情况。对于所有统计分析，p值<0.05被视为具有统计学意义。结果 216名患者的平均年龄（±标准差（SD））为40.48（±11.87）岁。在本研究中，参与者报告身体领域的生活质量得分平均（±SD）为55.48（±8.006），心理领域为64.87（±6.920）,独立程度领域为54.95（±5.308），社会关系领域为60.67（±5.586），环境领域为67.98（±3.940），精神/宗教/个人信仰（SRPB）领域为49.42（±5.202）。生活质量总得分被发现为57.79（±3.248）,每月的总平均经济负担评估为36,182.94印度卢比（±5606.98）。该研究表明自变量——总医疗费用（p值=0.022）、工资损失（p值=0.005）和总经济负担（p值=0.004）——与生活质量总得分之间存在显著关联。结论经济负担在影响艾滋病毒/艾滋病感染者生活方面起着重要作用。需要有针对艾滋病毒和艾滋病感染者需求的金融干预和康复项目，这不仅会给他们一种安全感，还会使他们拥有一个感到受欢迎并对生活满意的社区。
