Abstract
BackgroundHealth-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilization of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV (PLHIV), and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia.MethodsA cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centers participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Global Physical Health (GPH) and Global Mental Health (GPH) summary scores were employed. GPH and GMH summary scores below 50 (the standardized mean score) were determined as poor HRQoL. Bivariate and multivariate logistic regression analyses were used to identify factors associated with GPH and GMH summary scores.ResultsThis study included 259 (66.4%) females and 131 (33.6%) males. The GPH summary scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a GPH summary score of below 50; the GMH summary scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has a GMH summary score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor GPH and poor GMH summary scores. Age below 25 years and being a member of Christian fellowship were inversely associated with poor GPH. The least wealth index score and CD4 count below 350 cells/mL were also associated with poor GMH.ConclusionOverall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLHIV. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximize PLHIVs’ HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLHIV.
Highlights
Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilization of health care has on quality of life
Improving the overall wellbeing and life expectancy of people living with Human immunodeficiency virus (HIV) (PLHIV), managing HIV/acquired immune deficiency syndrome (AIDS) as a chronic and survivable disease, determining the social inequalities associated with HRQoL and evaluating the impact of the disease on the HRQoL of people affected by HIV/AIDS are essential to plan better social and health-care services [9, 10]
It was shown that those PLHIVs who reported to have a current CD4 count below 350 cells/mL were 1.91 times likely to have poor Global Mental Health (GMH) than those whose CD4 count was above 350 cells/mL (AOR 1.91; 95% Confidence interval (CI) 1.14, 3.21; p = 0.014)
Summary
Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilization of health care has on quality of life. By the end of 2018, an estimated 37.9 million people were living with HIV and AIDS globally, and 1.7 million people were newly infected by HIV [6] To contain such an enormous number of people living with HIV and manage the disease that was once considered to be lethal, HIV care has advanced in terms of both technology and service delivery [7, 8]. Improving the overall wellbeing and life expectancy of people living with HIV (PLHIV), managing HIV/AIDS as a chronic and survivable disease, determining the social inequalities associated with HRQoL and evaluating the impact of the disease on the HRQoL of people affected by HIV/AIDS are essential to plan better social and health-care services [9, 10]
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