Abstract
BackgroundHIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is now of particular concern. The objectives of this paper were to describe self-rated health among PLHIV, on ART and on ART virally suppressed and to analyse its determinants.MethodsData were obtained from a second-generation surveillance system based on a cross-sectional one-day survey in public hospitals. Epidemiological and clinical data were collected among HIV-infected inpatients and outpatients receiving HIV-related care the day of the survey in 86 hospitals in 2019. Self-rated health was measured using a question included in the National Health Survey: “In the last 12 months, how would you rate your health status?” an ordinal variable with five categories (very good, good, moderate, bad and very bad). For the analysis, these responses were dichotomized into two categories: 1 = very good/good and 0 = moderate, bad or very bad health status. Factors associated with very good/good self-rated health were estimated using logistic regression.ResultsOf 800 PLHIV, 67.5% perceived their health as very good/good, 68.4% among PLHIV on ART and 71.7% of those virally suppressed. Having university education (adjusted odds ratio (aOR):2.1), being unemployed (aOR:0.3) or retired (aOR:0.2), ever being diagnosed of AIDS (aOR:0.6), comorbidities (aOR:0.3), less than 2 year since HIV diagnosis (aOR:0.3) and not receiving ART (aOR:0.3) were associated with good self-rated health. Moreover, among PLHIV on ART, viral load less than 200 copies (aOR:3.2) were related to better perceived health. Bad adherence was inversely associated with good self-rated health among PLHIV on ART (aOR:0.5) and of those virally suppressed (aOR:0.4).ConclusionsNearly seven in 10 PLHIV in Spain considered their health status as very good/good, being higher among virally suppressed PLHIV. Both demographic and clinical determinants affect quality of life.
Highlights
HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is of particular concern
Among the 24 cases who were not receiving antiretroviral treatment (ART) at the time of the study, treatment had been delayed in 15 patients for medical reasons, and the reason was unknown for the remaining cases
95% confidence interval (95% CI) Confidence interval 95%, PLHIV People living with HIV, ART antiretroviral treatment, MSM Men who have sex with men, PWID People who injected drugs good or good self-rated health was lower among those ever diagnosed of acquired immunodeficiency syndrome (AIDS) (53.9%), patients with viral load more than 200 copies (33.8%) or low CD4 count (20.9%), with comorbidities (33.0%) and not receiving ART (44.4%)
Summary
HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is of particular concern. In 2014, the Joint United Nations Programme on HIV/ AIDS (UNAIDS) launched the 90–90-90 strategy. This target directed efforts towards testing and treatment in order to achieve the goal of 90% of people living with HIV (PLHIV) being diagnosed, 90% of those diagnosed receiving ART and 90% of those receiving ART having viral load suppression, i.e., at least 73% of all PLHIV worldwide being virally suppressed [3]. The fourth 90 set the objective that 90% of PLHIV with viral load suppression have a good health-related quality of life (HRQoL) [5]
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