The Importance of Positive Psychological Factors among People Living with HIV: A Comparative Study

Beyond antiretroviral treatment: Health-related quality of life of patients receiving antiretroviral treatment at a tertiary hospital in South Africa

Antiretroviral therapy (ART) has significantly transformed the management of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), positively impacting the health-related quality of life (HRQoL) and life expectancy of people living with HIV and AIDS (PLWHA). HRQoL is a critical consideration for HIV and AIDS patients as it reflects their overall well-being and treatment outcomes. This study aimed to investigate the HRQoL of PLWHA receiving an ART regimen containing tenofovir, lamivudine, and dolutegravir at a tertiary hospital in Johannesburg, South Africa. This descriptive, quantitative, cross-sectional study included 103 patients who consented in writing to participate. Data was collected using WHOQOL HIV-BREF, socio-demographic, health characteristics, and adherence questionnaires. Participants who reported 'excellent' and 'very good' on the descriptive rating scale were considered to have optimal adherence (≥95 %). This study's statistical significance was set at p ≤ 0.05. More than half of the participants were male (n = 53; 51.5 %), employed (n = 54; 52.4 %) had an income less than 2000 South African Rands (n = 59; 57.3 %), and reported high levels of adherence over a 7-day (n = 71; 68.9 %) and 4-week (n = 70; 67.9 %) reporting period. Majority of the sample considered their health as 'good' (n = 82; 79.6 %) and did not consider themselves ill (n = 85; 82.5 %). This study found that education level, income, health status, and perception of illness significantly (p ≤ 0.05) affected most domains of HRQoL and Overall HRQoL. While adherent (≥95 %) patients indicated superior HRQoL across most dimensions relative to non-adherent (≥95 %) patients, significant disparities in mean scores were exclusively noted only in the psychological domain (p = 0.01). Multivariate linear regression analysis revealed that level of education (Ꞵ = 1.18; p = 0.01), income (Ꞵ = 0.72; p = 0.00), perception of illness (Ꞵ = 1.75; p < 0.001), and health status (Ꞵ = 1.68; p < 0.001) are the predictors of overall HRQoL. Monitoring HRQoL in HIV patients is essential for providing holistic care and improving outcomes. By addressing comorbidities, psychosocial challenges, and unmet needs, healthcare providers can enhance the overall well-being and HRQoL of PLWHA.

The association between fear of progression and medical coping strategies among people living with HIV: a cross-sectional study

BACKGROUND

Due to the chronic nature of HIV, mental health has become a critical concern in people living with HIV (PLWHIV). However, little knowledge exists about the association between fear of progression (FoP) and medical coping modes (MCMs) in PLWHIV in China.

METHODS

A cohort of 303 PLWHIV were consecutively enrolled and their demographic, clinical and psychological information was collected. The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS), Internalized HIV Stigma Scale (IHSS) and MCMs Questionnaire were utilized.

RESULTS

Of the participants, 215 PLWHIV were classified into the low-level FoP group, and 88 were grouped into the high-level FoP group based on their FoP-Q-SF scores, according to the criteria for the classification of dysfunctional FoP in cancer patients. The high-level group had a higher proportion of acquired immunodeficiency syndrome (AIDS) stage (P = 0.005), lower education levels (P = 0.027) and lower income levels (P = 0.031). Additionally, the high-level group had lower scores in social support (P < 0.001) and its three dimensions, with total SSRS scores showing a negative correlation with two dimensions of FoP-Q-SF, namely physical health (r2 = 0.0409, P < 0.001) and social family (r2 = 0.0422, P < 0.001). Further, the high-level group had higher scores in four dimensions of internalized HIV stigma, and a positive relationship was found to exist between IHSS scores and FoP-Q-SF scores for physical health (r2 = 0.0960, P < 0.001) and social family (r2 = 0.0719, P < 0.001). Social support (OR = 0.929, P = 0.001), being at the AIDS stage (OR = 3.795, P = 0.001), and internalized HIV stigma (OR = 1.028, P < 0.001) were independent factors for FoP. Furthermore, intended MCMs were evaluated. FoP were positively correlated with avoidance scores (r2 = 0.0886, P < 0.001) and was validated as the only factor for the mode of confrontation (OR = 0.944, P = 0.001) and avoidance (OR = 1.059, P = 0.001) in multivariate analysis.

CONCLUSION

The incidence of dysfunctional FoP in our study population was relatively high. High-level FoP was associated with poor social support, high-level internalized HIV stigma and a negative MCM among PLWHIV.