Abstract
Despite significant advances in antiretroviral therapy, unmet basic needs can negatively impact health-related quality of life (HRQoL) in people living with HIV, especially as they age. We aimed to examine the effect of unmet basic needs across age groups on changes in HRQoL over a 4-year period in persons with HIV. Physical and mental HRQoL scores from the Positive Spaces, Healthy Spaces cohort interviewed in 2006 (n = 538), 2007 (n = 506), and 2009 (n = 406) were examined across three age groups according to their unmet needs for food, clothing, and housing. Individual growth curve model analyses were used to investigate changes over time, adjusting for demographics, employment, living conditions, social supports, HIV status, and health behavior risks. Low scores on physical and mental HRQoL were positively associated with higher number of unmet basic needs (β = −6.40, standard error (SE) = 0.87, p < 0.001 and β = −7.39, SE = 1.00, p < 0.001, respectively). There was a slight improvement in physical and mental HRQoL over 4 years in this HIV cohort, but the burden of unmet basic needs took its toll on those over 50 years of age. Regularly assessing unmet basic needs is recommended given the impact these can have on HRQOL for people living with HIV. Recognition of unmet needs is vital, as is the development of timely interventions.
Highlights
An estimated 37.7 million people are living with HIV globally, 27.5 million of whom, at the end of 2020, were on antiretroviral therapy [1]
HIV infection can lead to persistent inflammation [5], as well as chronic immune activation [6] and immunosenescence [7,8], all of which accelerate the natural process of aging [9]
All data were initially collected via face-to-face interviews conducted by trained peer research associate (PRA) interviewers who, themselves, were persons living with HIV
Summary
An estimated 37.7 million people are living with HIV globally, 27.5 million of whom, at the end of 2020, were on antiretroviral therapy [1]. An estimated one in six of all Canadians living with HIV (15 years or older) will reach the age of 50 years within the five years [4]. People living with HIV face numerous health challenges. HIV infection can lead to persistent inflammation [5], as well as chronic immune activation [6] and immunosenescence [7,8], all of which accelerate the natural process of aging [9]. Aging itself is frequently accompanied by additional and multiple chronic health conditions [10,11]. An accumulation of pathologies, coupled with the natural process of aging, too often negatively affects
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