<p>Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia</p>

Abstract

Background: The human immunodeficiency virus (HIV) continues to be a major global public health problem with more than 35 million people worldwide infected so far. Evidence shows that HIV has been compromising the quality of life of people living with HIV (PLWH) even in this era of highly active anti-retroviral therapy (HAART). There has been little research into the quality of life of PLWH receiving HAART in Ethiopia. Purpose: The aim of this study was to assess the quality of life among PLWH attending anti-retroviral therapy at public health facilities of Arba Minch town, Southern Ethiopia, in 2019. Patients and methods: We conducted a cross-sectional study design on 391 randomly selected PLWH who were attending HAART. We used a systematic random sampling technique to select participants in public health facilities of Arba Minch town from February 16 to April 26, 2019. The interviewers administered a structured questionnaire consisting of the WHOQOL-HIV BREF tool to measure the quality of life. Socio-demographic variables of study participants were collected, together with variables related to their clinical status extracted from their clinical records. Percentage mean scores were calculated and the mean of percentage mean scores was taken as the cutoff to categorize participants into two groups representing poor and good quality of life. Simple binary logistic regression and multivariable logistic regression analyses were used to determine significant variables. All variables with p-value ≤ 0.25 in simple binary logistic regression were considered as eligible variables for multivariable logistic regression. Variables with p-value ≤ 0.05 in multivariable logistic regression were considered as predictor variables. Results: Out of the 391 enrolled adult PLWH, 184 of them (47.1%) had poor of overall quality of life status, as estimated by the WHOQOL-HIV BREF tool. Good quality of life was positively associated with recent CD4 count greater than or equal to 500 cell/mm 3 (AOR=1.96, 95% CI; 1.18-3.27), absence of depression (AOR=10.59, 95% CI; 6.16-18.21), normal body mass index (AOR=2.66, 95% CI; 1.18-3.27), social support (AOR= 6.18, 95% CI; 3.56-10.75) and no perceived stigma (AOR=2.75, 95% CI; 1.62-4.67). Conclusion: Nearly half of the adult PLWH receiving HAARTat Arba Minch town had poor quality of life. High CD4 count, lack of social support, depression, and perceived stigma were associated with poor quality of life of PLWH. PLWH should be encouraged to be part of structured social support systems, such as associations of people living with HIVand mother support groups, in order to improve their social and psychological health. The health system should give attention to counseling on chronic care adherence and nutritional support to improve the quality of life of PLWH receiving HAART.

Health related quality of life of people receiving highly active antiretroviral therapy in Southwest Ethiopia

“…From this finding, patients who get a continuous support from their family were 3.12 times more likely to have high global score of QoL. The positive impact of family support on patients QoL is also cited in previous studies [ 9 , 41 – 43 ]. Family support is important for patients to feel secure, enhance self-confidence, minimize stress, and discrimination.…”

HIV Disclosure and Quality of Life in People Living with HIV/AIDS in Yogyakarta

“…It is consistent with Indonesia's research (Handayani, Ratnasari, Husna, Marni, & Susanto, 2019). However, it is somewhat different from the results of two studies conducted in South Africa, where the physical domain is in the third and fifthlowest positions in the quality of life domain (Cronje, Williams, Steenkamp, Venter, & Elkonin, 2017;Tesemma, Abate, Abebo, & Madebo, 2019). The higher PLWHA disclosure gets, the more opportunity the PLWHA get to do more physical activities akin to ordinary people.…”

“…The second-lowest outcome of the quality-of-life domain based on status disclosure is the environmental domain (p = .008; r = .353) (Table 2). This research differ from research in North Africa, where the environmental domain is the highest (Tesemma et al, 2019). Openness can have a good impact on the environment; health care service is one example.…”

“…It is per with the research result which stated that PLWHA was challenged to attend their daily living tasks, participate in high physical activities, or have sufficient energy or vitality to engage in an active social life while managing HIV/AIDS (Basavaraj, Navya, & Rashmi, 2010). Pain, fatigue, poor nutrition, lack of rest and low CD4 cells are associated with physical limitations and disabilities from PLWHA (Basavaraj et al, 2010;Cronje et al, 2017;Handayani et al, 2019;Tesemma et al, 2019). PLWHA who have CD4above 500 and normal nutritional status have QOL of 1.96 and 2.66 compared to their counterparts (Tesemma et al, 2019).…”

“…Pain, fatigue, poor nutrition, lack of rest and low CD4 cells are associated with physical limitations and disabilities from PLWHA (Basavaraj et al, 2010;Cronje et al, 2017;Handayani et al, 2019;Tesemma et al, 2019). PLWHA who have CD4above 500 and normal nutritional status have QOL of 1.96 and 2.66 compared to their counterparts (Tesemma et al, 2019).…”