Quality of Life and Associated Factors in HIV-infected Adults Undergoing Antiretroviral Treatment at CHUD-Borgou

Abstract

<i>Introduction</i>: Antiretrovirals have improved the life expectancy of people living with HIV (PLHIV). The evaluation of quality of life and its improvement is now an important element of care. The current study assessed the quality of life and identified associated factors with adults living with HIV who were followed at the CHUD Borgou. <i>Methods</i>: A case-control study was conducted from August to October 2018. Cases of PLHIV aged 15 years and older, were recruited through systematic sampling with steps equal to 2 based on the order of arrival of patients at the site. The controls were composed of apparently healthy, HIV-negative individuals recruited in the community in 10 neighborhoods selected at random out of 58 in the city of Parakou. A pen rotation was used to choose the direction to follow and households were selected with a step size of 4. Each PLHIV is associated with two HIV-negative respondents matched on age, sex, and average monthly income. The generic score composed of 36 questions "SF-36" was used to assess the quality of life of the participants. These questions are grouped into three categories exploring physical, mental, and self-perceived health changes, respectively. Respondents gave oral consent. The favorable opinion of the ethics committee for Biomedical research of the University of Parakou was obtained. Data were entered and analyzed using Epi-Info 7.2.2 software. The general linear regression model was used to identify independent factors associated with quality of life. <i>Results</i>: There were 222 PLHIV and 444 HIV-negative subjects. The mean quality of life score of PLHIV was higher than that of HIV-negative subjects in all dimensions: physical health (56.04 vs. 50.52; p ˂ 0.000), mental health (40.15 vs. 35.16; p ˂ 0.000), and perceived health (67.00 vs. 59.40; p < 0.000). PLHIV had a low vitality score compared with controls (53.67 vs 54.85; p = 0.215). Independent factors associated with quality of life were: age < 40 years (p=0.001), male gender (p=0.046), shared HIV status with spouse (p=0.045), existence of psychological support (p=0.026), length of time since testing (p=0.041), last CD4 ≥ 500 (p=0.025). <i>Conclusion</i>: Several factors contribute to a better quality of life for PLHIV compared to the community. The impact of free care in Benin on the quality of life of PLHIV deserves to be evaluated in the long term.