Abstract
BackgroundIn South Africa, HIV is increasingly becoming a chronic disease as a result of advances in HIV treatment and prevention in the last three decades. This has changed the perception from a life threating to a potentially manageable disease. However, little is known about self-perceived health status of HIV-infected individuals. Self-rated health (SRH) has been shown to be a sensitive indicator of health-relatedchanges directly linked to HIV, but can also be influenced by differences in social and material conditions. The aim of this paper was to identify determinants of excellent/good SRH among HIV-infected individuals using socio-demographic, life style and health related data.MethodsThe study used data from the nationally representative 2012 South African population-based household survey on HIV prevalence, incidence and behaviour conducted using multi-stage stratified cluster sampling design. Bivariate and multivariate logistic regression models were used to identify determinants of SRH among HIV-infected individuals.ResultsOut of a total of 2632 HIV positive participants 74.1% (95% CI: 68.4-74.2) reported excellent/good SRH. Increased likelihood of reporting excellent/good SRH was significantly associated with being Black African [OR= 1.97 (95%CI: 1.12-3.46), p = 0.019] and belonging to least poor household [OR= 3.13 (95%CI: 1.26-7.78), p = 0.014]. Decreased likelihood of reporting excellent/good SRH was significantly associated with those aged 25 to 34 years [OR= 0.49 (95% CI: 0.31-0.78), p = 0.003], 35 to 44 years[OR= 0.27 (95% CI: 0.17-0.44), p < 0.001], 45 to 54 years [OR= 0.20 (95% CI: 0.12-0.34), p < 0.001], and those 55 years and older [OR= 0.15 (95% CI: 0.09-0.26), p < 0.001], hospitalization in the past twelve months [OR= 0.40 (95% CI: 0.26-0.60), p < 0.001].ConclusionTo have positive health effects and improve the perceived health status for PLWH social interventions should seek to enhance to support for the elderly HIV-positive individuals, and address the challenge of socio-economic inequalities and underlying comorbid conditions resulting in hospitalization.
Highlights
In South Africa, Human immunodeficiency virus (HIV) is increasingly becoming a chronic disease as a result of advances in HIV treatment and prevention in the last three decades
Participants were selected using multi-stage stratified cluster sampling using a stratified master sample of 1000 census enumerator areas (EA) sampled from a South African listing of 86,000 Enumeration areas (EAs) from the 2001 population census stratified by province, race group and locality type
Four questionnaires were administered to persons of different age groups in the household each containing various age-specific modules soliciting information related to socio-demographic factors, HIV knowledge, attitudes, practices, and behaviours including general health [1]
Summary
In South Africa, HIV is increasingly becoming a chronic disease as a result of advances in HIV treatment and prevention in the last three decades. This has changed the perception from a life threating to a potentially manageable disease. People living with HIV (PLHIV) have had a greatly improved life expectancy All these successes including mass media, social and behavioural change communication campaigns against HIV have changed the perception of HIV from a life threating to a potentially manageable disease especially among PLHIV [1, 2, 4]. SRH has been shown to be influenced by differences in social and material conditions attributed to predisposing demographic and socio-economic factors such as age, gender, education level and employment status, place residence/geographic location and behavioural/ lifestyle factors such as smoking, alcohol use, and physical inactivity [5,6,7,8,9,10]
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