Functional Status and Overall Quality of Life in a Multiethnic HIV-Positive Population

Abstract

The objective of this study was to examine the sociodemographic and behavioral variables associated with quality of life (QOL) among multiethnic, economically disadvantaged patients with HIV/AIDS. A cross-sectional survey was conducted in a large inner-city HIV/AIDS clinic serving medically indigent residents of Houston, Texas, and the surrounding area. On arrival at the clinic, patients were systematically approached and asked to complete a questionnaire, offered in both English and Spanish. Demographic characteristics, stage of disease, and behavioral variables were assessed in addition to work-role functioning and overall health-related QOL. Multiple regression analysis was conducted to assess the relationships between the variables of interest. Of 617 patients approached and asked to participate in the study, 385 (62.4%) consented to complete the questionnaire. Demographic composition of the sample was as follows: 78% male, 25% white, 44% black, and 29% Hispanic. Forty-five percent of the participants were infected through men having sex with men (MSM), 35% through heterosexual contact, and 11% through injection drug use. Racial/ethnic minorities reported significantly (p < 0.05) poorer physical functioning and work-role functioning. Participants with higher nadir CD4 cell counts (> 500 per cubic millimeter), MSM HIV exposure, and more education (beyond high school) reported better physical functioning and work-role functioning. Overall QOL and work-related functioning were significantly impaired in this patient population. The impaired functional status findings hold for every social, demographic, and behavioral subgroup examined. Findings suggest that the influence of social inequality persist even among a universally disadvantaged population.

Assessing a conceptual framework of health-related quality of life in a HIV/AIDS population

“…Findings suggest that even among a uniformly low-income patient population, low SES continues to be significantly associated with poorer functional status and HRQOL. The relationship between SES and functional status has been observed in previous studies, with lower SES associated with poorer HRQOL [7,8,31,32]. However, this study is among the first to demonstrate this association in the context of a structural equation model.…”

Enhancing Labour Force Participation for People Living with HIV: A Multi-Perspective Summary of the Research Evidence

“…[88,89] Some studies also reported differential factors related to employment outcomes including decreased levels of physical functioning, and lower quality of life. [89,90] Finally, the labour force participation literature suggested that economic factors disproportionately affected PHAs from ethnic minority groups, the consequences of which are higher levels of unemployment, poorer access to treatment and a high degree of uncertainty regarding the course of illness. [87,91] Marginalization due to gender and poverty create obstacles to employment for many women living with HIV.…”

Nature and correlates of SF-12 physical and mental quality of life components among low-income HIV adults using an HIV service center

“…However, little evidence exists from studies conducted in urban indigent populations. In a study by Vidrine et al [22] examining medically indigent persons with HIV, overall QOL was reported as being significantly impaired but few differences were observed across demographic groups. Further examination of demographic characteristics associated with differences in HRQOL in a low-income population may contribute to our understanding of HRQOL in this population.…”

“…Quality of life scores among HIV patients were found to be significantly lower than general population norms in studies conducted in Canada [4], Venezuela [13], the UK [18], and the US [22,26]. Instruments used in previous studies to assess HRQOL include the SF-36 [4,13], the SF-12 [22,26], and the MOS-HIV [18]. No study was found that compared HRQOL among economically disadvantaged HIV patients to normative data.…”