Abstract
PurposeThis study aimed to investigate changes in health-related quality of life (HRQoL) among people newly diagnosed with HIV and to identify factors associated with HRQoL.MethodsNewly diagnosed HIV-positive individuals were consecutively recruited and assessed at baseline and 1-year follow-up after diagnosis. HRQoL was measured through the physical health summary score (PHS) and mental health summary score (MHS) derived from the Medical Outcomes Study HIV Health Survey. Socio-demographic, clinical, and psychological information was also collected at both times. Generalized estimating equations were applied to explore factors associated with HRQoL in 1 year.ResultsA total of 410 participants were included. After 1 year, significant increases were observed for both the mean PHS score (53.5–55.0; p = 0.009) and the mean MHS score (44.2–49.0; p < 0.001). Older age (p = 0.024), rural household registration (p = 0.031), HIV-related symptoms (p < 0.001), and depression (p = 0.014) were negatively associated with PHS. Additionally, the negative association between stress and PHS increased over time (β = − 0.07 for the baseline; β = − 0.18 for the 12-month follow-up; p < 0.001). HIV-related symptoms, depression, lower social support, and higher levels of stress (all p < 0.001) were negatively associated with MHS. Additionally, the negative relationship between stress and MHS was stronger among participants who were asymptomatic (p = 0.015).ConclusionA relatively lower HRQoL among HIV-infected people shortly after HIV diagnosis and an increase in HRQoL among people 1 year after HIV diagnosis were observed. Additional attention should be paid to individuals of older age, from rural areas, with HIV-related symptoms, with depression, with high levels of stress, and with a lack of social support.
Highlights
It has been estimated that by the end of 2017, a cumulative total of 758,610 people were living with HIV in China, with increasing HIV cases over the years [1]
After 1 year, 2 (1.5%) participants had died, and 145 participants were withdrawn from the study for the following reasons: a geographic move (n = 35, 23.8%), a loss of contact (n = 35, 23.8%), and refusal to participate in the follow-up survey (n = 75, 51.0%)
Of the 410 participants remaining in this study, 218 (53.2%) initiated antiretroviral therapy (ART) during follow-up with a median total treatment duration of 6 months (IQR 4–9), and 48.8% had a rural household registration
Summary
It has been estimated that by the end of 2017, a cumulative total of 758,610 people were living with HIV in China, with increasing HIV cases over the years [1]. As the Chinese government scaled up the National Free Antiretroviral Treatment Programme (NFATP) in 2003, approximately 542,000 people in China were receiving antiretroviral therapy (ART) by the end of June 2017 [2]. A dramatic decline in mortality and morbidity has been found among HIV-infected individuals [3]. The focus of HIV–AIDS care has been shifting from increasing life expectancy to the improving health-related quality of life (HRQoL) [5].
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