Life In HIV Research Articles

Influence of childhood trauma, HIV infection, alcohol use disorder, and resilience on health-related quality of life in adulthood

Experience of childhood trauma, especially physical, emotional, and sexual abuse, carries a risk for developing alcohol use disorder (AUD) and engaging in risky behaviors that can result in HIV infection. AUD and HIV are associated with compromised self-reported health-related quality of life (HRQoL) possibly intersecting with childhood trauma. To determine whether poor HRQoL is heightened by AUD, HIV, their comorbidity (AUD + HIV), number of trauma events, or poor resilience, 108 AUD, 45 HIV, 52 AUD + HIV, and 67 controls completed the SF-21 HRQoL, Brief Resilience Scale (BRS), Ego Resiliency Scale (ER-89), and an interview about childhood trauma. Of the 272 participants, 116 reported a trauma history before age 18. Participants had a blood draw, AUDIT questionnaire, and interview about lifetime alcohol consumption. AUD, HIV, and AUD + HIV had lower scores on HRQoL and resilience composite comprising the BRS and ER-89 than controls. Greater resilience was a significant predictor of better quality of life in all groups. HRQoL was differentially moderated in AUD and HIV: more childhood traumas predicted poorer quality of life in AUD and controls, whereas higher T-lymphocyte count contributed to better quality of life in HIV. This study is novel in revealing a detrimental impact on HRQoL from AUD, HIV, and their comorbidity, with differential negative contribution from trauma and beneficial effect of resilience to quality of life. Channeling positive effects of resilience and reducing the incidence and negative impact of childhood trauma may have beneficial effects on health-related quality of life in adulthood independent of diagnosis.

Impact of Loneliness on Brain Health and Quality of Life Among Adults Living With HIV in Canada.

People aging with HIV are at risk for loneliness, with stigmatization and economic marginalization added to the health challenges arising from chronic infection. This study provides evidence for the extent, contributors, and consequences of loneliness in people living with HIV, focusing on brain health and quality of life. Cross-sectional data from 856 middle-aged and older adults living with HIV recruited from 5 urban specialty clinics in Canada were drawn from the inaugural visit of the Positive Brain Health Now cohort study. Participants completed an extensive assessment of biopsychosocial variables. The prevalence, severity, and quality of life impact of self-reported loneliness were described. Clinical and environmental factors hypothesized as contributing to loneliness, and the consequences of loneliness on health and function were identified using logistic, ordinal, and linear regression. Eighteen percent reported being "quite often" and 46% "sometimes" lonely. Those with more loneliness were younger, less mobile, suffered more financial hardship, and were more likely to use opioids. HIV symptoms, pain, fatigue, low motivation, stigma, and unemployment were related to loneliness. Loneliness increased the odds of cognitive impairment, low mood, stress, and poor physical health. Those who were "quite often" lonely were over 4 times more likely to report poor or very poor quality of life than those who were "almost never" lonely. Loneliness is common in middle-aged and older people living with HIV in Canada. Many of the associated factors are modifiable, offering novel targets for improving brain health, general health, and quality of life in HIV.

Frailty and Neurocognitive Impairment: Impacts on Quality of Life in HIV.

Little is known about the effects of aging-related conditions on health-related quality of life (HRQOL) among people living with HIV (PLWH). The purpose of our study was to examine the independent effects of neurocognitive impairment (NCI) and frailty and the interactive effects with HIV serostatus on HRQOL. Our sample consisted of 121 adults (63 PLWH and 58 HIV-uninfected) participating in the Multi-Dimensional Successful Aging among HIV-Infected Adults study at the University of California, San Diego. HRQOL was measured with the Medical Outcome Study 36-Item Short Form Health Survey scale. We found that frailty was significantly associated with HRQOL (p < .001) in the overall sample, and this effect was significantly stronger for PLWH than HIV-uninfected adults. NCI was not significantly associated with HRQOL in our sample. Frailty may be a particularly important factor in HRQOL for PLWH, highlighting the need for prevention and intervention strategies to mitigate the risks for frailty.

Oral Health-related Quality of Life in HIV: A Systematic Review

To systematically evaluate the literature evidence related to oral health and quality of life (QoL) among HIV-positive adults. The oral health-related quality of life (OHRQoL) is an essential entity to be measured for understanding the domains affected due to oral health problems. HIV comes with an array of complexities in the oral cavity and is also reflection of the systemic illness of the oral cavity. Hence, it is essential to know the area affected and also the lesions that contribute the most to decrease the QoL in this aspect. A systematic review was carried out in relation to studies across PubMed and Google Scholar regarding HIV and OHRQoL from January 1970 to May 2019. Of the 1,374 articles screened, 11 studies were filtered for the final review. The physical domain followed by the psychological domain is the most affected in the HIV-positive patients. The maximum effect is due to dental caries and periodontitis. No studies report about oral substance abuse and its effect. Studies are further needed on a larger sample size and on similar scales and parameters to ensure greater evidence for intervention related to areas that should be focused upon for improving the QoL of HIV-positive patients. There is a greater need to include quality-based assessment while treating HIV-positive people. Also not just physical indicators like pain or dental caries, even social indicators like mental and social dimensions of a patient's life should be included while deciding the treatment approach.

THE RELATIONSHIP SELF-FORGIVENESS WITH QUALITY OF LIFE IN HIV / AIDS PATIENTS AT POLYCLINIC VCT MOJOKERTO REGENCY

ABSTRACT&#x0D; &#x0D; The number of people with HIV / AIDS is like an iceberg, which appears to be only a small part. At present, HIV cannot be cured. This condition has a comprehensive impact on patients. Through Self-forgiveness, it is expected that patients can reduce negative feelings or emotions, so that they will be motivated to change their behavior for the better. The research objective proved the relationship self forgiveness with quality of life in HIV/AIDS patients. The research design was analytic correlation with Cross Sectional approach. The Sample was all patient of HIV / AIDS (selected who were diagnosed with HIV / AIDS because of sexual relations) who undergoing treatment in Polyclinic VCT Mojokerto Regency amounting to 122 people, with consecutive sampling. The independent variable was self forgiveness and the dependent variable was quality of life in HIV/AIDS patients. The instrument used a HFS (Heartland Forgiveness Scale) questionnaire for self-forgiveness. WHOQOL-HIV BREF for quality of life. The result of Spearman-Rho Correlation showed significant = 0.000, so a positive relationship between Self-Forgiveness and Quality of Life in HIV / AIDS. Respondents who have high self-forgiveness, also have a good quality of life, as many as 55 respondents (44.8%) and very good, that is as many as 25 respondents (20.7%). Forgiveness can affect the physical health of individuals and the factors that affect self-forgiveness, namely, the emergence of empathy, emotional intelligence, self-reflection, and personality characteristics. Improvement of quality of life can occur if the HIV / AIDS patient has been able to accept his condition, transforming himself into an open person and always apply the forgiveness attitude and can forgive or forgive the incident ever done by himself or others, so as to neutralize the negative feelings into positive.&#x0D; Keywords: Self Forgiveness. Quality of Life, HIV/AIDS&#x0D;

THE RELATIONSHIP SELF-FORGIVENESS WITH QUALITY OF LIFE IN HIV / AIDS PATIENTS AT POLYCLINIC VCT MOJOKERTO REGENCY

ABSTRACT&#x0D; &#x0D; The number of people with HIV / AIDS is like an iceberg, which appears to be only a small part. At present, HIV cannot be cured. This condition has a comprehensive impact on patients. Through Self-forgiveness, it is expected that patients can reduce negative feelings or emotions, so that they will be motivated to change their behavior for the better. The research objective proved the relationship self forgiveness with quality of life in HIV/AIDS patients. The research design was analytic correlation with Cross Sectional approach. The Sample was all patient of HIV / AIDS (selected who were diagnosed with HIV / AIDS because of sexual relations) who undergoing treatment in Polyclinic VCT Mojokerto Regency amounting to 122 people, with consecutive sampling. The independent variable was self forgiveness and the dependent variable was quality of life in HIV/AIDS patients. The instrument used a HFS (Heartland Forgiveness Scale) questionnaire for self-forgiveness. WHOQOL-HIV BREF for quality of life. The result of Spearman-Rho Correlation showed significant = 0.000, so a positive relationship between Self-Forgiveness and Quality of Life in HIV / AIDS. Respondents who have high self-forgiveness, also have a good quality of life, as many as 55 respondents (44.8%) and very good, that is as many as 25 respondents (20.7%). Forgiveness can affect the physical health of individuals and the factors that affect self-forgiveness, namely, the emergence of empathy, emotional intelligence, self-reflection, and personality characteristics. Improvement of quality of life can occur if the HIV / AIDS patient has been able to accept his condition, transforming himself into an open person and always apply the forgiveness attitude and can forgive or forgive the incident ever done by himself or others, so as to neutralize the negative feelings into positive.&#x0D; Keywords: Self Forgiveness. Quality of Life, HIV/AIDS&#x0D;

Exercise Improves Cardiovascular Risk Factors, Fitness, and Quality Of Life in Hiv+ Children and Adolescents: Pilot Study

Criancas e adolescentes infectados pelo HIV atraves da transmissao mae-filho tem alto risco de desenvolver doencas cardiovasculares precoces devido a dislipidemia, resistencia a insulina e inflamacao cronica de baixo grau. O objetivo do estudo piloto foi analisar o efeito de um programa de exercicios fisicos ludicos sobre os desfechos cardiovasculares, morfologicos, metabolicos, de aptidao e qualidade de vida. Um ensaio clinico nao-randomizado composto por 24 sessoes de exercicios aerobicos e resistidos foi aplicado a 10 criancas e adolescentes vivendo com o HIV, oriundos de Florianopolis, SC, Brasil. As seguintes variaveis foram obtidas antes e apos o programa: colesterol total, HDL-c, LDL-c, triglicerideos, glicose, proteina-C reativa em jejum, pressao arterial, espessura intima-media da arteria carotida comum (EIM-ACC), resistencia muscular, aptidao aerobia, antropometria e qualidade de vida medida. Apos a intervencao, observou-se diminuicao da pressao arterial sistolica (-6,8 mmHg, 6,6%, p = 0,019) e EIM-ACC (-60,0 µm, 12,2%; p = 0,002) apos 24 sessoes. Observou-se aumento na resistencia muscular dos membros superiores (+3,3 rep.min-1, 63,5%, p = 0,002), flexibilidade (+5,7 cm, 26,0%; p = 0,001) e qualidade de vida (+10,4 pontos, 27,5%, p = 0,003). Em nossa amostra de criancas e adolescentes vivendo com o HIV, um programa de exercicios de curta duracao foi associado com melhora no risco cardiovascular, aptidao fisica e qualidade de vida.

Spontaneous and post-treatment HCV clearance: relationships with health-related quality of life in HIV infection (ANRS-VESPA2 study)

Background: Post-treatment clearance of HCV is associated with improved health-related quality of life (HRQL) in HIV–HCV co-infection. However, the potential differences in HRQL between post-treatment and spontaneous clearers remain poorly documented. Methods: Linear regression models were used to assess the relationships between HCV status and HRQL (PROQOL-HIV scale) in 411 co-infected adults followed-up in French hospitals in 2011 (ANRS-VESPA2 survey). Results: After adjustment for socio-economic and clinical factors, patients previously exposed to HCV treatment showed better physical HRQL and better experience of HIV treatment than treatment-naive HCV-chronic patients. Post-treatment clearers showed better mental HRQL. Spontaneous clearers showed better experience of HIV treatment. Conclusion: Spontaneous and post-treatment HCV clearance may influence different dimensions of HRQL of HIV–HCV co-infected patients. Further studies in real-life settings are needed to document patient-reported outcomes in the era of direct-acting antiviral agents for HCV treatment.

Effectiveness of Hope-Oriented Group Therapy on Improving Quality of Life in HIV+ Male Patients

The purpose of this study was to investigate effectiveness of hope-oriented group therapy on improving quality of life in a group of male HIV+ patients. MethodMethodologically, this study is semi-experimental study, pre-test and post-test with control group. Participants are 20 male patients infected by HIV who had been referred to EMAM-KHOMIEINI hospital in Tehran. They were randomly assigned into experimental and control groups. WHO's Quality of Life brief specific questionnaire was used as instrument. It consists of 26 questions.Results Results of t-test for independent groups indicated that experimental group's quality of life scores after treatment had improved, in regard to control group(p=0/05).Discussion The results of study indicate that hope-oriented group therapy improves quality of life in men suffering from HIV.

Attachment, forgiveness, and physical health quality of life in HIV + adults

Research aims to help HIV + individuals improve and maintain a healthy quality of life, while managing a chronic illness. Using Lazarus and Folkman's model of stress and coping, we examined the main and interactive effects of attachment style and forgiveness on physical health quality of life of HIV + adults. Participants (n=288, 49% women) were recruited in Dallas/Fort Worth and self-identified as African-American (52%), European-American (32%), Latino(a) (12%), and other (4%), with an average age of 41.7 (SD=8.6). The average number of years participants reported being HIV + was 7.6 (SD=5.4). Participants completed medical and demographic information, measures assessing attachment anxiety and avoidance, forgiveness of self and others, and five quality of life scales (physical functioning, pain, role functioning, social functioning, and health perceptions). Significant correlations revealed that attachment anxiety was inversely related to physical health quality of life, while forgiveness of self was associated with greater quality of life. Hierarchical multiple regression analyses revealed that attachment anxiety and avoidance, forgiveness of self and others, as well as interactions between attachment style and forgiveness, were related to the physical health quality of life of HIV + adults. Interpretation of the interactions identified that for individuals who endorsed greater attachment anxiety, forgiveness of others was associated with greater pain, while forgiveness of self was associated with a greater perception of health. Research has indicated that forgiveness interventions lead to positive health outcomes for most individuals; however, in HIV + adults, whether an outcome is health promoting may be dependent on attachment style.

Mastery and Coping Moderate the Negative Effect of Acute and Chronic Stressors on Mental Health-Related Quality of Life in HIV

Acute and chronic life stressors have a detrimental effect on the health of people living with HIV. Psychosocial resources such as mastery, coping, and social support may play a critical role in moderating the negative effects of stressors on health-related quality of life. A total of 758 participants provided baseline enrolment data on demographics (age, gender, ethnicity, sexual orientation, education, employment, income), clinical variables (CD4 counts, viral load, AIDS-defining condition, time since HIV diagnosis), psychosocial resources (mastery, coping, social support), life stressors (National Population Health Survey [NPHS] Stress Questionnaire), and health-related quality of life (SF-36). We performed hierarchical multivariate regression analyses to evaluate the potential moderating effects of psychosocial resources on the relationship between stressors and health-related quality of life. The top three stressors reported by participants were trying to take on too many things at once (51%), not having enough money to buy the things they needed (51%), and having something happen during childhood that scared them so much that they thought about it years later (42%). Life stressors were significantly and inversely associated with both physical and mental health-related quality of life. Mastery and maladaptive coping had significant moderating effects on mental health but not on physical health. These results suggest that developing interventions that improve mastery and reduce maladaptive coping may minimize the negative impact of life stressors on the mental health of people with HIV. They also highlight that it is important for clinicians to be mindful of the impact of life stressors on the health of patients living with HIV.

Advances in nutrition support for quality of life in HIV+/AIDS.

Globally, acquired immunodeficiency syndrome (AIDS) is an epidemic, severe and fatal disease. Along with the etiological factors of human immunodeficiency virus infection (HIV+) and decreased immunity, there are a number of other risk factors including opportunistic infection, malnutrition, wasting syndrome, and oxidative stress. The nutritional problems have been shown to be significant and contribute to health and death in HIV+/AIDS patients. Weight loss, lean tissue depletion, lipoatrophy, loss of appetite, diarrhea, and the hypermetabolic state each increase risk of death. The role of nutrition and how oxidative stress is involved in the pathogenesis of HIV+ leading to AIDS is reviewed. Studies consistently show that serum antioxidant vitamins and minerals decrease while oxidative stress increases during AIDS progression. The optimization of nutritional status, intervention with foods and supplements, including nutrients and other bio-active food components, are needed to maintain the immune system. Various food components may be recommended to reduce the incidence and severity of infectious illnesses by forms of bio-protection which include reduced oxidative stress due to reactive oxygen species which stimulate HIV replication and AIDS progression. Probiotics or lactic acid bacteria and prebiotics are sometimes given on the presumed basis that they help maintain integrity of mucosal surfaces, improve antibody responses and increase white blood cell production. People with HIV+/AIDS can be informed about the basic concepts of optimal nutrition by identifying key foods and nutrients, along with lifestyle changes, that contribute to a strengthened immune system. Moreover, nutritional management, counseling and education should be beneficial to the quality and extension of life in AIDS.

A Literature review measuring quality of life in HIV and AIDS and influencing factors

随着人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者生命的延长,生存质量(quality of life , QOL)这一反映健康的指标日益受到关注和重视.2000年,WHO和联合国艾滋病规划署(UNAIDS)提出,在降低发病率和死亡率的同时,把提高与健康相关的生存质量作为关怀和支持HIV感染者和艾滋病患者的第3个目标[1].作者就近年来HIV感染者和艾滋病患者生存质量研究方面的进展进行综述。

How do patients with HIV/AIDS understand and respond to health value questions?

Utility assessment involves assigning values to experienced or unfamiliar health states. Pivotal to utility assessment, then, is how one conceptualizes health states such as "current health" and "perfect health." The purpose of this study was to ascertain how patients with HIV think about and value health and health states. We conducted open-ended in-depth interviews with 32 patients with HIV infection purposefully sampled from a multicenter study of quality of life in HIV. After undergoing computer-assisted utility assessment using the rating scale, time tradeoff, and standard gamble methods, patients were asked how they thought about the utility tasks and about the terms "current health" and "perfect health." Patients understood the health valuation tasks but conceptualized health states in different ways. Many patients believed that "perfect health" was a mythical health state, and some questioned whether it was even desirable. "Current health" was variably interpreted as the status quo; deteriorating over time; or potentially improving with the hope of a cure. Patients with HIV infection vary in the way they conceptualize health states central to utility assessment, such as perfect health and current health. Better understanding of these issues could make important methodologic and policy-level contributions.

Domains of Life Satisfaction Among Patients Living With HIV: A Factor Analytic Study of the Quality of Life Inventory

This study sought to identify multidimensional factors of life satisfaction in individuals with HIV through a factor analysis of the Quality of Life Inventory (QOLI), and to examine the relationship of these factors to health-related quality of life, depression, and medication adherence. Four quality of life domains emerged: Achievement, Self-Expression, Environment, and Interpersonal Relationships. QOLI means were substantially lower than the normative means and were significantly related to the SF-12 mental (but not the physical) component summary. Multidimensional assessments of quality of life in HIV may help specify targets sensitive to psychosocial interventions.

Health-related quality of life of patients with HIV: Impact of sociodemographic, clinical and psychosocial factors

This study aims to analyse how a wide group of clinical, social, demographic and psychological factors are related to both physical and mental quality of life in HIV + patients. A cross-sectional study was carried out of 320 HIV + patients in antiretroviral treatment who attended infectious diseases units in four hospitals in the region of Andalusia (Spain). Health-Related Quality of Life was measured by the MOS-HIV. Included as independent variables were: sociodemographic variables, variables related to antiretroviral therapy, psychosocial variables like social support (Duke-UNC-11) and psychological morbidity (GHQ-28), variables related to main risk behaviours and clinical variables. In the multiple linear regression analysis, a better PHS quality of life was found to be associated with the absence of mental illness, social support, not being an intravenous drug user and using more than one type of non-injectable drug. A better quality of life, in mental terms, was found to be associated with fewer years as a non-intravenous drug user, having social support, absence of mental illness, not being an intravenous drug user taking only one additional pill, not having any difficulty in taking the medication, and being female. The study of other non-biological factors that may be related to quality of life has been limited practically to social support and the emotional state. This study highlights the importance of these factors independently from the clinical state, as well as the existence of other psychological and behavioural factors that are also related.

Lipodystrophy and quality of life in HIV: symptom management issues

The purpose of this study was to examine the incidence and prevalence of lipodystrophy-related symptoms in persons with HIV ( n = 165) and to determine the impact of these symptoms on health-related quality of life. Since the introduction of highly active antiretroviral therapy in HIV, the quality of life of persons is affected across the spectrum of the disease. The sample was composed of 165 persons from three national outpatient HIV settings (clinics and community-based organizations) in Boston, MA, Fresno, CA, and Victoria, TX. The descriptive, cross-sectional study included self-report instruments measuring lipodystrophy-associated symptom presence, intensity, and quality of life. The sample was primarily male (75.8%), with ethnicity represented across several groups including African American (30.9%), Hispanic/Latino (26.7%), White/Anglo (38.8%), Native American/Indian (1.8%), and other (1.8%). On quality-of-life measures, only 7.9% of the sample indicated excellent health, 28.5% indicated very good health, 22.4% indicated good health, and more than 40% indicated fair or poor health. Most of the participants indicated that aspects of their quality of life have equally good and bad parts (37.6%). Quality of life was significantly correlated with adequacy of income ( r = .241, p = .002), most recent CD4 count ( r = −.276, p = .012), and most recent viral load value ( r = .379, p = .019). In addition, bodily pain was significantly correlated with most recent CD4 count ( r = −.312, p = .004) and with lowest CD4 count ( r = −.191, p = .050). The results of the study indicate that quality of life is affected by HIV symptoms and that lipodystrophy-related symptoms may negatively affect quality of life.

Impact of Chronic Viral Hepatitis on Health-Related Quality of Life in HIV: Results from a Nationally Representative Sample

Little is known about the health burden of chronic viral hepatitis in HIV-infected patients. We compared health-related quality of life (HRQOL) of patients with HIV and hepatitis C virus (HCV) or HIV and hepatitis B virus (HBV) coinfection to those with HIV monoinfection. Using a nationally representative sample of 1,874 adults with HIV who completed a baseline and two follow-up interviews, we identified those with HIV monoinfection (n = 1,493), HIV-HCV coinfection (n = 279), and HIV-HBV coinfection (n = 122). We measured baseline and change over time scores for physical and mental health (PHS, MHS), overall quality of life (QOL), overall health, and disability days. To identify the independent effect of coinfection, we adjusted for demographic and clinical predictors of HRQOL using multivariable regression. Despite significant differences in socio-demographic characteristics between groups, there were no differences in the baseline scores for PHS, MHS, overall QOL, overall health, or disability days between groups. The HRQOL did not decline significantly over time for the HIV patients with or without HCV or HBV coinfection. All groups reported similar longitudinal changes in the HRQOL scores for all measures. We found no significant differences in disease burden as assessed by a generic HRQOL instrument between patients with HIV monoinfection and HIV-HCV or HIV-HBV coinfection. These data are relevant in counseling coinfected patients regarding the impact of coinfection on HRQOL, and are important in designing clinical trials and conducting cost-effectiveness analyses including this vulnerable cohort.

Measuring Quality of Life in HIV and AIDS: A Review of the Recent Literature

This review addresses some of the recent issues surrounding the measurement of quality of life of people living with HIV and AIDS and discusses the properties of suitable instruments. More than 300 articles on quality of life in HIV and AIDS published since 1995 have been appraised. The structure and properties of two broad types of measure are considered: economic indicators or scales and subjective measures. While several good scales have been created for the assessment of people living with HIV infection, few were found to be conceptually comprehensive in terms of the dimensions offered for evaluation. Almost all these instruments were developed in the USA. Simple translation methods provide language versions that lack cross-cultural equivalence. A new cross-cultural methodology has recently been achieved in the development of the WHOQOL-HIV instrument as a measure for international research and its development is described.

Management of Antiretroviral-Related Nutritional Problems: Challenges and Future Directions

Survival has been greatly enhanced with the adequate and effective treatment of HIV infection. Surviving and surviving well are important pieces of the disease management puzzle. Nutritional well-being has been closely associated with both survival and quality of life in HIV and other diseases. The effects and interactions of currently used antiretroviral therapies can compromise nutritional well-being. The challenges posed to researchers, clinicians, and patients in evaluating and treating nutrition-related effects of life-saving antiretroviral medications affect health care goals, recommendations, and decisions. Challenges include identifying emerging problems, prioritizing clinical problems, expediting the implementation of clinical trials, developing research-based interventions that are realistic and usable in practice, decreasing the time lag to incorporate research findings into practice, and developing or adapting evidence-based clinical guidelines. This article will explore these challenges, offer thought-provoking questions in the development of research and clinically viable solutions, and propose future directions for management strategies of antiretroviral-related problems.