Quality of life in people living with HIV in Romania and Spain

Meaghan Kall,Graham Brown,Florentina Dumitrescu,Ujué Fresán,Valerie Delpech,Jesús Castilla,Cristina Burgui,Victor Ionel Grecu,Danielle Guy,Jeffrey V Lazarus

doi:10.1186/s12879-021-06567-w

Abstract

BackgroundHealth-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as HIV. The aim of the study was to examine and compare the health-related quality of life of people living with HIV in Romania and Spain, compared to the general populations of each country.MethodsA cross-sectional survey was conducted among adults (≥ 18 years) attending for HIV care in Romania and Spain from October 2019 to March 2020. The survey included two validated HRQoL instruments: a generic instrument, EQ-5D-5L, and an HIV-specific instrument, PozQoL, and questions on socio-demographics, HIV-related characteristics, physical and mental health conditions, and substance use. Multivariable linear regression was used to determine factors associated with HRQoL.Results570 people living with HIV responded (170 in Romania and 400 in Spain). The median age was 31 (18–67) in Romania and 52 (19–83) in Spain. Anxiety/depression symptoms were frequently reported by people with HIV (Romania: 50% vs 30% in the Romanian population; Spain: 38% vs 15% in Spanish population). Spain reported higher mean EQ-5Dutility scores than Romania (0.88 and 0.85, respectively) but identical PozQoL scores (3.5, on a scale of 0–5). In both countries, health concerns were highlighted as a key issue for people with HIV. In multivariable analysis, two factors were consistently associated with worse HRQoL in people with HIV: bad or very bad self-rated health status and presence of a mental health condition. In Romania, being gay/bisexual and being disabled/unemployed were associated with worse HRQoL. Whereas in Spain, older age and financial insecurity were significant predictors.ConclusionsOur results indicated a good HRQoL for people living with HIV in Romania and Spain; however, worse HRQoL profiles were characterized by health concerns, poor self-rated health status, and the presence of mental health conditions. This study highlights the importance of monitoring HRQoL in people living with HIV due to the chronic nature of the disease. In this highly-treatment experienced group, disparities were found, particularly highlighting mental health as an area which needs more attention to improve the well-being of people living with HIV.

Highlights

Health-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as Human Immunodeficiency virus (HIV)
People living with HIV (PLHIV) can expect a normal life expectancy through combination antiretroviral therapy (ART) when diagnosed and provided treatment promptly, they continue to face a disproportionate burden of chronic health problems, challenges of lifelong treatment and associated side-effects as well as psychological challenges including stigma and discrimination [2, 3]
We describe the distribution of EurQoL five dimensions questionnaire (EQ-5D) domains among people living with HIV compared to the general population in both countries, and determine factors associated with a lower HRQoL

Summary

Introduction

Health-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as HIV. The aim of the study was to examine and compare the health-related quality of life of people living with HIV in Romania and Spain, compared to the general populations of each country. As such, measuring HRQoL is a crucial component in assessing and addressing the unmet needs of various populations, especially those with chronic illnesses, such as HIV. HRQoL data can be used to identify disparities between different populations and help to inform interventions that will ensure long-term retention in care, ART adherence and maintenance of good health [8]. There have been calls to formally consider good HRQoL as part of the “fourth 90” for people with HIV alongside the UNAIDS 90-90-90 targets to monitor the health system response to HIV [9]

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