Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors
Abstract Background: Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilisation of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV and AIDS, and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia.Methods: A cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centres participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Physical Health Summary (PHS) and Mental Health Summary (MHS) scores were employed. PHS and MHS scores below 50 (the standardised mean score) were determined to be poor and above 50 to be good. Bivariate and multivariate logistic regression analyses were used to identify factors associated with PHS and MHS scores.Results: This study included 259 (66.4%) females and 131 (33.6%) males. The PHS scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a PHS score of below 50; the MHS scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has an MHS score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor PHS and poor MHS scores. The demographic factors associated with poor PHS scores were being a member of the Oromo ethnic group and having non-Christian religious affiliations; while age of below 25 years were inversely associated with poor PHS. The least wealth index score was also associated with a poor MHS score.Conclusion: Overall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLWHA. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximise PLWHAs’ HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLWHAs.