Understanding the quality of life of people living with HIV in rural and urban areas in Indonesia

Health-Related Quality of Life Among Patients Living with HIV/AIDS in Vietnam: A Cross-Sectional Study

Background

HIV/AIDS remains a major public health concern in Vietnam. While advancements in antiretroviral therapy (ART) have significantly enhanced survival rates and transformed HIV into a manageable chronic condition, the health-related quality of life (HRQL) of people living with HIV/AIDS (PLHA) often falls short of optimal levels.

Purpose

This study aims to evaluate the HRQL of HIV/AIDS outpatients at the Hospital for Tropical Diseases in Vietnam and identify key factors impacting their well-being.

Methods

A cross-sectional study was conducted among 328 PLHA receiving care at the Hospital for Tropical Diseases between March 2023 to March 2024. Data was collected using the World Health Organization Quality of Life-HIV Brief Version (WHOQOL-HIV BREF) instrument and included socio-demographic, clinical, and treatment-related variables. Descriptive statistics were utilized to summarize the data. Inferential statistical analyses, including independent t-test, one-way ANOVA, Kruskal-Wallis tests, and linear regression, were performed to evaluate the relationships between HRQL domains and participant characteristics. Statistical significance was set at p < 0.05.

Results

The mean overall quality of life score was 14.6 ± 2.2. The highest domain scores were observed in spirituality (15.1 ± 3.5) and environment (15.1 ± 2.9), while the lowest was in the physical domain (14.1 ± 2.0). Significant determinants of overall quality of life included age, marital status, employment type, income, financial difficulties, chronic diseases, and CD4 counts (all p < 0.05).

Conclusion

This study highlights the multifaceted challenges affecting the quality of life of PLHA, emphasizing the need for a holistic care approach. Being married, having stable employment, and having higher CD4 counts were associated with better quality of life, whereas older age, unstable income, financial struggles, and comorbidities were linked to poorer outcomes. Interventions addressing these determinants, including chronic disease management, social and mental health support are crucial for enhancing overall well-being.

Mental Health Symptoms Between Developed and Developing Regions for People Living With HIV in China: A Network Analysis of 40 Psychological Symptom Scales

BACKGROUND

People living with HIV (PLWH) frequently encounter mental health symptoms. Yet, a notable gap exists regarding the divergence in core mental health symptoms among PLWH across developed and developing regions. This study aims to explore the differences in mental health symptom networks among PLWH in both developed and developing regions.

METHODS

A multicenter cross-sectional study was conducted in China from April 2022 to April 2023. Six designated HIV hospitals enrolled 2436 participants, including 1430 PLWH from developed regions and 1006 PLWH from developing regions. The study assessed 40 mental health symptoms across six dimensions: somatization symptoms, negative affect, cognitive processes, cognitive function, interpersonal communication, and social adaptation among PLWH.

RESULTS

The diverse developed regions exhibited varying mental health symptoms among PLWH, particularly concerning their core symptoms. In the developed regions of China, PLWH predominantly experience core symptoms centered around "Sadness," "Anger," and "Distress." In contrast, PLWH from developing regions tends to manifest core symptoms such as "Inability to integrate into society," "Difficulty in managing daily work and study," and "Hostility."

CONCLUSIONS

The regional variation in mental health symptoms among PLWH underscores the disparities in their circumstances. This insight is crucial for crafting tailored intervention strategies for urban PLWH. In developed regions, psychological interventions such as catharsis and empathy are integral to clinical practice, while in less developed regions, family support interventions are paramount, given the limited social interactions available to PLWH.

REPORTING METHOD

This study was reported according to the STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Correction: Understanding the quality of life of people living with HIV in rural and urban areas in Indonesia

[This corrects the article DOI: 10.1371/journal.pone.0280087.].

Lived experience, social support, and challenges to health service use during the COVID-19 pandemic among HIV key populations in Indonesia

The COVID-19 pandemic has greatly affected the lives, health, and social well-being of people globally including presenting special challenges in low to middle income countries for people living with HIV. This study investigates the pandemic experiences of the four key HIV-positive populations in Indonesia: men who have sex with men, transgender women, female sex workers, and people who use drugs. In-depth interviews were conducted with a convenience sample of 22 key population members recruited through 9 nongovernment HIV agencies in Jakarta and Bali, Indonesia. Indonesia's Large-scale Social Restrictions Policy mandating physical distancing and stay-at-home orders had been in effect for 7-10 months at the time of the interviews. The interviews were audio-recorded, transcribed, and coded using NVivo™ (R1.7) software. A grounded theory approach identified key concepts along with similarities, differences, and reoccurring patterns of COVID-19 lived experience among participants. Participants recounted the impact of both the pandemic and the Restriction Policy on their interpersonal, financial, medical, and psychosocial well-being. When in need, they turned to formal and informal sources of financial and social support plus their own resourcefulness. Along with other factors, HIV medication shortages, HIV and COVID-19 related stigma, and fear of acquiring COVID-19 negatively impacted their antiretroviral adherence and the use of health services. The results point to the latent consequences of government attempts to curb a pandemic through public health lockdowns and enforced policies of physical separation. Its findings reveal the importance of ensuring that public safety nets for HIV key populations are available to supplement more informal personal sources of needed support.

"I Was Very Shocked, I Wanted It to Be Over": A Qualitative Exploration of Suicidal Ideation and Attempts among Women Living with HIV in Indonesia

HIV diagnosis and poor HIV management have various detrimental impacts on the lives of people living with HIV (PLHIV). As a part of a large qualitative study investigating HIV risk factors and impacts, of which the topic of suicide is not a focus, this paper describes the factors contributing to suicidal ideation and attempts that arose naturally in the stories of women living with HIV (WLHIV; n = 52) in Yogyakarta and Belu districts, Indonesia. The participants were recruited using the snowball sampling technique. Guided by a qualitative data analysis framework, the data were thematically analysed. The findings were grouped into four main themes: (i) the women experienced immense psychological challenges due to the infection, spousal transmission, fear of mother-to-child transmission, and losing a child due to AIDS, which triggered suicidal ideation and attempts; (ii) the lack of awareness of HIV management strategies resulted in them feeling trapped and overwhelmed, and the associated negative thoughts and the anticipation and experience of HIV stigma influenced their thoughts of suicide; (iii) the lack of social support from family and friends during the early stages of HIV diagnosis, compounded with pre-existing financial difficulties, lack of income, unemployment, and feeling overburdened, also triggered the women's thoughts of suicide; and (iv) family breakdown following HIV diagnosis, concern about future relationships, and fear of being rejected or abandoned by their partner were also influencing factors for suicidal ideation and attempts among the women. The findings indicate the need for a nuanced approach to counselling within HIV care interventions for couples to support the acceptance of each other's HIV status whilst maintaining psychological wellbeing. Additionally, the findings indicate the importance of HIV education and awareness among community members for the de-stigmatisation of HIV and to increase the acceptance of PLHIV by their families and communities.