Variations in self-rated health among patients with HIV infection.

TitleVariations in self-rated health among patients with HIV infection.
Publication TypeJournal Article
Year of Publication2006
AuthorsMrus JM, Schackman BR, Wu AW, Freedberg KA, Tsevat J, Yi MS, Zackin R
JournalQual Life Res
Volume15
Issue3
Pagination503-14
Date Published2006 Apr
ISSN0962-9343
KeywordsAdult, Female, HIV Infections, Humans, Male, Meta-Analysis as Topic, Quality of Life, Randomized Controlled Trials as Topic, Self Disclosure, Surveys and Questionnaires
Abstract

PURPOSE: To assess how patients with HIV who are enrolled in a clinical trials cohort rate their health and to compare their ratings with those of patients with HIV from 2 other cohorts: the HIV Cost and Services Utilization Study (HCSUS), and Adult AIDS Clinical Trials Group protocol 320 (ACTG 320).

METHODS: We analyzed baseline information for the 1649 subjects enrolled in the Adult AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) study prior to March 2002 who had self-rated health data available. We compared those results with results from 2 other groups: HCSUS, the only nationally representative sample of people in care for HIV in the U.S., which conducted baseline interviews in 1996 and 1997, and ACTG 320, a randomized, double-blinded, placebo-controlled trial comparing a 3-drug antiretroviral regimen with a 2-drug combination, which enrolled subjects in the same general time frame as HCSUS. We used t tests, Pearson correlations, and linear regression to determine factors associated with self-rated health and z scores to compare results between cohorts.

RESULTS: The mean (SD) rating scale value on a 0-100 scale for ALLRT participants was 79.8 (16.8). Values were significantly lower for subjects who were older, had a history of injection drug use, had lower CD4 cell counts, or were beginning salvage antiretroviral therapy. Subjects in ALLRT reported significantly better self-rated health at baseline than those in HCSUS or ACTG 320 (11-12% higher rating scale values in ALLRT; p<0.05). When cohort differences were accounted for through regression and stratification, the differences in scores between subjects in ALLRT and HCSUS increased and the differences in scores between subjects in ALLRT and ACTG 320 diminished.

CONCLUSIONS: Self-rated health varied significantly by age, CD4 count, injection drug use history, and salvage therapy status. Differences in self-rated health for clinical trials and non-clinical trials samples appear to be substantial and should be considered when applying trial results to clinical populations.

DOI10.1007/s11136-005-1946-4
Alternate JournalQual Life Res
PubMed ID16547789
Grant ListK01 DA017179 / DA / NIDA NIH HHS / United States
K01-DA017179 / DA / NIDA NIH HHS / United States
K23 HD044556 / HD / NICHD NIH HHS / United States
K23-HD044556 / HD / NICHD NIH HHS / United States
K24 AI062476 / AI / NIAID NIH HHS / United States
K24 AT001676 / AT / NCCIH NIH HHS / United States
K24-AI062476 / AI / NIAID NIH HHS / United States
K24-AT001676 / AT / NCCIH NIH HHS / United States
P30 AI060354 / AI / NIAID NIH HHS / United States
P30-AI060354 / AI / NIAID NIH HHS / United States
R01 AI042006 / AI / NIAID NIH HHS / United States
R01-AI42006 / AI / NIAID NIH HHS / United States
U01 AI025897 / AI / NIAID NIH HHS / United States
U01 AI027668 / AI / NIAID NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI038858 / AI / NIAID NIH HHS / United States
U01 AI046386 / AI / NIAID NIH HHS / United States
U01-AI25897 / AI / NIAID NIH HHS / United States
U01-AI27668 / AI / NIAID NIH HHS / United States
U01-AI38855 / AI / NIAID NIH HHS / United States
U01-AI38858 / AI / NIAID NIH HHS / United States
U01-AI42006 / AI / NIAID NIH HHS / United States
U01-AI46386 / AI / NIAID NIH HHS / United States