Abstract
Few studies have investigated the impact of antiretroviral treatment on the self-rated health of people living with HIV/AIDS. Self-rated health provides a global assessment of an individuals’ health status, encompassing several dimensions that no other single health outcome is able to capture. In this paper, we investigate the self-rated health of HIV-infected people receiving antiretroviral treatment at two different time-points, the time of interview and the time of antiretroviral initiation. A life-event history survey was carried-out among 513 HIV-infected individuals receiving treatment in four community hospitals in Chiang Mai province, Northern Thailand. Interviews cover their family, residential, education, occupation and health history including self-rated health over their lifespan. The proportion of participants reporting poor or very poor health decreased dramatically from 56% before treatment initiation to 6% at the time of interview. This huge improvement in self-rated health paralleled with clinical and biological markers. At the time of interview, factors independently associated with better self-rated health were the absence of symptoms and an immunological recovery (Odd Ratios (OR): 2.22 and 1.52, respectively). At treatment initiation, the absence of symptoms, of severe immunosuppression and no history of hospitalization were independently associated with better self-rated health (OR: 2.22, 1.52, and 3.11, respectively). These results confirm the validity of the self-rated health indicator in the particular context of HIV/AIDS.
Highlights
With more than one million people infected since the beginning of the HIV epidemic, mostly through heterosexual contacts, Thailand remains the most severely hit country in South-east Asia
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) (WHO/UNAIDS, 2014), in 2013 the prevalence of HIV was estimated at 1.1% among adults aged 15 to 49 years old, with a total of 440,000 people living with HIV/AIDS
With improved survival due to antiretroviral treatments, increased attention is paid to the quality of life of people living with HIV/AIDS (Bing et al, 2000; Briongos Figuero, Bachiller Luque, Palacios Martin, Gonzalez Sagrado, & Eiros Bouza, 2011; Duracinsky, Herrmann, et al, 2012)
Summary
With more than one million people infected since the beginning of the HIV epidemic, mostly through heterosexual contacts, Thailand remains the most severely hit country in South-east Asia. Few studies have investigated their self-rated health, which is an important component of quality of life (Harding et al, 2012; Koelmeyer, English, Smith, & Grierson, 2014; Liu et al, 2006; Mrus et al, 2006; Munyati et al, 2006). Because it is both global and easy-to-collect, self-rated health is widely used in surveys and in evaluation programmes. Important determinants of self-rated health are unhealthy behaviours, mental health and psychosocial factors (e.g., personality traits, coping styles)
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