Quality of life among individuals with HIV starting antiretroviral therapy in diverse resource-limited areas of the world.

TitleQuality of life among individuals with HIV starting antiretroviral therapy in diverse resource-limited areas of the world.
Publication TypeJournal Article
Year of Publication2012
AuthorsSafren SA, Hendriksen ES, Smeaton L, Celentano DD, Hosseinipour MC, Barnett R, Guanira J, Flanigan T, Kumarasamy N, Klingman K, Campbell T
JournalAIDS Behav
Volume16
Issue2
Pagination266-77
Date Published2012 Feb
ISSN1573-3254
KeywordsAdult, Africa, Anti-HIV Agents, Asia, CD4 Lymphocyte Count, Developing Countries, Female, Haiti, HIV Seropositivity, HIV-1, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, South America, Surveys and Questionnaires, Treatment Outcome, United States, Viral Load
Abstract

As Antiretroviral Therapy (ART) is scaled up in low- and middle-income countries, it is important to understand Quality of Life (QOL) correlates including disease severity and person characteristics and to determine the extent of between-country differences among those with HIV. QOL and medical data were collected from 1,563 of the 1,571 participants at entry into a randomized clinical trial of ART conducted in the U.S. (n = 203) and 8 resource-limited countries (n = 1,360) in the Caribbean, South America, Asia, and Africa. Participants were interviewed prior to initiation of ART using a modified version of the ACTG SF-21, a health-related QOL measure including 8 subscales: general health perception, physical functioning, role functioning, social functioning, cognitive functioning, pain, mental health, and energy/fatigue. Other measures included demographics, CD4+ lymphocyte count, plasma HIV-1 RNA viral load. Higher quality of life in each of the 8 QOL subscales was associated with higher CD4+ lymphocyte category. General health perception, physical functioning, role functioning, and energy/fatigue varied by plasma HIV-1 RNA viral load categories. Each QOL subscale included significant variation by country. Only the social functioning subscale varied by sex, with men having greater impairments than women, and only the physical functioning subscale varied by age category. This was the first large-scale international ART trial to conduct a standardized assessment of QOL in diverse international settings, thus demonstrating that implementation of the behavioral assessment was feasible. QOL indicators at study entry varied with disease severity, demographics, and country. The relationship of these measures to treatment outcomes can and should be examined in clinical trials of ART in resource-limited settings using similar methodologies.

DOI10.1007/s10461-011-9947-5
Alternate JournalAIDS Behav
PubMed ID21499794
PubMed Central IDPMC3182285
Grant List1U01AI069426-01 / AI / NIAID NIH HHS / United States
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MOIRR00865 / / PHS HHS / United States
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