Quality of life of people with HIV/AIDS - the influence of social determinants and disease-related factors

This cross-sectional epidemiological study was conducted at a specialized HIV/AIDS health facility of the Brazilian Public Health Service. Data were collected using the HIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument.

RESULTS:

The study included 109 participants. Among the many significant statistical associations found in the study, the variables that had a greater effect on the domains assessed by the instrument were educational level, occupation, financial situation, ethnicity, and symptomatology.

CONCLUSIONS:

Sociodemographic factors and HIV/AIDS-related aspects were influential in the QoL of people living with HIV/AIDS.

Keywords:
Quality of life; HIV; Unified Health System

Domain	Items	M (SD)	Mdn (Q1; Q2)
General activity	6	67 (25)	71 (50; 88)
Satisfaction with life	4	67 (29)	69 (44; 94)
Health concerns	4	64 (35)	75 (38; 100)
Financial concerns	3	47 (37)	42 (8; 83)
Medication issues	5	74 (30)	85 (60; 100)
HIV acceptance	2	59 (39)	63 (25; 100)
Confidentiality concerns	5	46 (33)	40 (20; 80)
Provider trust	3	82 (25)	100 (67; 100)
Sexual activity	2	64 (40)	88 (25; 100)

Categories	GA	SL	HC	FC	MI	HA	CC	PT	SF
Age ⁺
18 -39 (n=35)	68 (25)	65 (28)	57 (40)	49 (36)	70 (31)	59 (38)	45 (33)	74 (30)	74 (30)
≥ 40 (n=74)	66 (26)	67 (30)	67 (33)	46 (37)	76 (30)	59 (40)	47 (33)	85 (22)	85 (22)
p value	0.656	0.678	0.167	0.728	0.357	0.912	0.736	0.052	0.052
Gender
F (n=48)	61 (24)	58 (29)	62 (36)	45 (35)	74 (25)	54 (42)	45 (34)	84 (22)	84 (22)
M (n=61)	71 (26)	73 (28)	66 (35)	48 (38)	74 (34)	63 (37)	47 (33)	80 (27)	80 (27)
p value	0.051	0.007*	0.579	0.669	0.997	0.214	0.701	0.466	0.466
Educational level
Primary (n=49)	63 (25)	64 (31)	^a 56 (36)	^a 34 (34)	^a 69 (33)	^a 53 (39)	47 (35)	87 (20)	87 (20)
Secondary (n=44)	66 (26)	67 (29)	^ab 65 (34)	^b 58 (37)	^b 76 (28)	^a 58 (40)	44 (31)	80 (26)	80 (26)
Tertiary (n=16)	80 (20)	74 (24)	^b 85 (29)	^b 59 (31)	^b 84 (28)	^b 80 (31)	53 (35)	74 (32)	74 (32)
p value	0.053	0.452	0.014*	0.002*	0.002*	0.049*	0.650	0.155	0.155
Marital status
Single (n=40)	69 (25)	70 (28)	59 (36)	51 (38)	75 (29)	55 (40)	45 (33)	79 (27)	79 (27)
Married (n=39)	66 (27)	63 (30)	68 (34)	45 (35)	72 (32)	63 (37)	48 (35)	78 (27)	78 (27)
Div. or widowed (n=30)	65 (24)	66 (30)	66 (36)	45 (38)	75 (31)	59 (41)	45 (32)	90 (18)	90 (18)
p value	0.784	0.509	0.537	0.714	0.714	0.677	0.878	0.109	0.109
Occupation
Employed (n=48)	72 (24)	73 (27)	69 (33)	51 (36)	75 (31)	63 (37)	37 (33)	78 (30)	78 (30)
Unemployed (n=61)	62 (26)	62 (30)	60 (37)	44 (37)	73 (30)	56 (41)	54 (32)	85 (20)	85 (20)
p value	0.048*	0.055	0.192	0.312	0.683	0.333	0.008*	0.164	0.164
Financial Situation
Work (n=21)	49 (24)	45 (32)	32 (34)	13 (18)	54 (38)	45 (39)	37 (30)	87 (19)	87 (19)
Equal or better (n=88)	71 (24)	72 (26)	72 (31)	55 (35)	79 (26)	63 (38)	49 (34)	81 (26)	81 (26)
p value	<0.001*	<0.001*	<0.001*	<0.001*	0.008*	0.058	0.141	0.213	0.213
Ethnicity
White (n=64)	69 (25)	64 (28)	69 (33)	52 (36)	80 (24)	59 (38)	48 (33)	82 (23)	82 (23)
Brown/black (n=45)	63 (26)	70 (30)	57 (39)	39 (37)	65 (36)	59 (41)	44 (33)	82 (27)	82 (27)
p value	0.220	0.358	0.071	0.070	0.013*	0.949	0.511	0.957	0.957
Sexual orientation
Heterosexual (n=90)	67 (25)	66 (30)	63 (36)	46 (37)	74 (29)	57 (39)	45 (33)	83 (24)	83 (24)
Homo/bisexual (n=19)	67 (29)	68 (27)	67 (34)	51 (36)	71 (36)	69 (37)	52 (36)	77 (29)	77 (29)
p value	0.929	0.838	0.708	0.616	0.611	0.226	0.447	0.327	0.327
Origin of HIV Infection
Sexual (n=81)	65 (26)	65 (30)	63 (37)	48 (36)	73 (31)	63 (39)	45 (33)	81 (25)	81 (25)
Blood (n=12)	76 (23)	83 (14)	64 (36)	42 (38)	81 (30)	50 (37)	58 (32)	94 (11)	94 (11)
Unknown (n=16)	67 (25)	63 (27)	70 (30)	47 (40)	70 (30)	48 (42)	42 (36)	78 (29)	78 (29)
p value	0.365	0.118	0.794	0.895	0.895	0.288	0.402	0.202	0.202
Symptoms
No (n=85)	71 (24)	71 (27)	70 (33)	51 (37)	78 (28)	62 (39)	49 (34)	83 (26)	83 (26)
Yes (n=24)	51 (22)	50 (32)	42 (35)	32 (31)	58 (32)	48 (39)	37 (30)	78 (22)	78 (22)
p value	<0.001*	0.002*	<0.001*	0.019*	0.003*	0.128	0.109	0.406	0.406
T-CD4 ⁺⁺
≤350 (n=22)	70 (25)	67 (32)	63 (36)	50 (37)	66 (37)	49 (44)	43 (32)	82 (28)	82 (28)
> 350 (n=87)	66 (26)	66 (28)	64 (36)	46 (37)	76 (28)	62 (38)	47 (34)	82 (24)	82 (24)
p value	0.455	0.924	0.892	0.711	0.284	0.192	0.626	0.990	0.990
V.L. ⁺⁺⁺
≤ 50 (n=75)	64 (27)	66 (30)	69 (35)	48 (37)	76 (31)	61 (40)	51 (35)	82 (25)	82 (25)
> 50 (n=34)	73 (21)	68 (28)	53 (36)	45 (37)	70 (30)	56 (38)	36 (28)	82 (26)	82 (26)
p value	0.929	0.929	0.929	0.929	0.929	0.929	0.929	0.929	0.929

Domains	Explanatory Variable	B	p-value	95%CI		R²
				LL	UL
General activity
	Constant	50,47	<0,001	39,14	61,81	0,232
	Higher education (primary)	12,32	0,046	0,22	24,43
	Financial situation (worse)	17,37	0,003	6,16	28,58
	Symptoms (no)	-16,61	0,002	-27,18	-6,04
	Viral level (≤50)	12,74	0,007	3,52	21,96
Satisfaction with life
	Constant	42,65	<0,001	28,66	56,64	0,232
	Gender (F)	13,66	0,008	3,64	23,67
	Financial situation (worse)	23,61	<0,001	10,76	36,47
	Symptoms (no)	-12,82	0,043	-25,19	-0,44
Health concerns
	Constant	14,30	0,278	-11,72	40,31	0,315
	Age*	0,57	0,025	0,07	1,07
	Higher education (primary)	22,47	0,009	5,68	39,25
	Financial situation (worse)	31,03	<0,001	15,99	46,08
	Symptoms (no)	-19,09	0,009	-33,27	-4,90
Financial concerns
	Constant	14,69	0,058	-0,53	29,92	0,269
	Higher education (primary)	15,40	0,016	2,92	27,88
	Ethnicity (white)	-12,60	0,046	-24,98	-0,23
	Financial situation (worse)	38,79	<0,001	23,32	54,25
Medication issues
	Constant	66,52	<0,001	52,53	80,51	0,200
	Financial situation (worse)	20,10	0,004	6,44	33,76
	Ethnicity (white)	-13,87	0,011	-24,49	-3,25
	Symptoms (no)	-14,81	0,026	-27,80	-1,82
HIV acceptance
	Constant	55,51	<0,001	47,64	63,38	0,051
	Higher education (primary)	24,96	0,018	4,43	45,49
Confidentiality concerns
	Constant	42,99	<0,001	33,20	52,77	0,147
	Occupation (employed)	20,06	0,001	7,89	32,23
	Symptoms (no)	-16,09	0,031	-30,70	-1,49
	Viral level (≤50)	-14,06	0,032	-26,85	-1,26
Provider trust
	Constant	76,55	<0,001	70,78	82,32	0,081
	Div. or widowed (single)	12,91	0,015	2,53	23,30
	Origin (sexual)	16,12	0,033	1,31	30,94
Sexual activity
	Constant	61,08	<0,001	49,42	72,74	0,168
	Gender (F)	17,80	0,015	3,54	32,07
	Symptoms (no)	-29,96	<0,001	-47,04	-12,87

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[1] Corresponding author: Profa. Clea Adas Saliba Garbin. e-mail:cgarbin@foa.unesp.br / brunowakayama@gmail.com