Predictors of quality of life of TB/HIV co-infected patients in the Northern region of Ghana

BACKGROUND

Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-morbidity continues to be a serious worldwide health issue, particularly in Sub-Saharan Africa. Studies on the quality of life (QOL) of TB/HIV co-infected patients guide stakeholders on the delivery of patient-centred healthcare. This study evaluated QOL of TB/HIV co-infected individuals and its contributing factors.

METHODS

We conducted a cross-sectional study among TB/HIV co-infected patients, receiving treatment at clinics in the Northern Region of Ghana. Simple random sampling technique was used to select 213 patients from 32 clinics. We gathered information on patients' QOL using the World Health Organization QOL-HIV BREF assessment tool. At a 5% level of significance, multiple logistic regression analyses were carried out to find correlates of QOL among the patients.

RESULTS

The mean age of the patients was (38.99 ± 14.00) years with most, 33.3% (71/213) aged 30-39 years. Males constituted 54.9% (117/213). About 30.0% (64/213) of the patients reported a good QOL. Being employed (aOR = 5.23, 95% CI: 1.87 - 14.60), and adhering to treatment (aOR = 6.36, 95% CI: 1.51 - 26.65) were significantly associated with a good QOL. Being depressed (aOR = 0.02, 95% CI: 0.03 - 0.29), stigmatized (aOR = 0.31, 95% CI : 0.11 - 0.84), and not exercising (aOR = 0.28, 95% CI: 0.12 - 0.67) were negatively associated with a good QOL.

CONCLUSION

Less than one-third of TB/HIV co-infected patients in the region have good QOL. To guarantee good QOL, modifiable predictors such as patients' physical activity and medication adherence should be targeted by the National AIDS and TB Control Programs.

Validation of Kiswahili version of WHOQOL-HIV BREF questionnaire among people living with HIV/AIDS in Tanzania- a cross sectional study

Introduction

World Health Organization (WHO) has developed HIV specific quality of life tool called World Health Organization Quality of Life brief questionnaire in HIV population (WHOQOL-HIV BREF) for assessing the quality of life of people living with HIV/AIDS (PLWHA). Despite its sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to assess its psychometric properties before its adoption. The study aimed at evaluating the validity and reliability of the Kiswahili version of the WHOQOL-HIV BREF questionnaire in Tanzania among people living with HIV/AIDS.

Methods

a cross-sectional study with 103 participants recruited via systematic random sampling. The internal consistency of the questionnaire was assessed by the Cronbach alpha coefficient. Validity of the WHOQOL-HIV BREF was assessed through analysis of construct, concurrent, convergent and discriminant validity. The model performance was assessed by exploratory and confirmatory factor analysis.

Results

the mean age of the participants was 40.5 ± 9.702 years. The internal consistency of the items of the Kiswahili version of WHOQOL-HIV BREF shows Cronbach's alpha values of 0.89-0.90 (p < 0.001). Analysis of test-retest reliability showed a statistically significant Intra-class correlation (ICC) of 0.91 - 0.92 (p < 0.001). The spiritual and physical domains were highly discriminated from the rest of the domains (Psychological, Environmental, Social and Independent domain).

Conclusion

Kiswahili WHOQOL-HIV BREF tool was found to have good validity and reliability among Tanzanian people living with HIV/AIDS. These findings provide support for the use of this tool in assessing the quality of life in Tanzania.

Factors affecting healthrelated quality of life of HIVinfected key population in Myanmar

This cross-sectional study examined factors affecting Health-related Quality of Life (HRQoL) among 273 HIV-infected key populations. This included, men who have sex with men (MSM), people, who inject drugs (PWID), and sex workers (SW), who were currently receiving antiretroviral therapy (ART) in Myanmar. Participants were recruited from four non-government clinics in four main cities. Overall HRQoL score derived from the WHOQOL-HIV BREF questionnaire was 86.08 ± 10.78. The lowest score was found in the environment domain (13.64 ±  2.06), while the highest score was found in the spirituality domain (15.54 ± 3.04). According to the multiple logistic regression analysis, participants, reported having an adequate income (OR = 3.32, P = 0.006), regularly taking meditation (OR = 3.79, P = 0.009), living in Tachileik (OR = 15.43, P = 0.011), and reported having no symptoms during previous 2 weeks (OR = 14.50, P < 0.001), were more likely to have good HRQoL level. In contrast, patients receiving ART < 1 year (OR = 0.163, P = 0.028) reported having low ART adherence (OR = 0.17, P = 0.018) and reported anticipated stigma (OR = 0.23, P < 0.001) and internalized stigma (OR = 0.29, P = 0.006) were less likely to have good HRQoL level.

Assessing the psychometric properties of the French WHOQOL-HIV BREF within the ANRS CO3 Aquitaine Cohort's QuAliV ancillary study

BACKGROUND

Antiretroviral therapy has prolonged the lives of those with human immunodeficiency virus (HIV), but the effects of chronic infection on their health-related quality of life (HRQoL) remain a concern. Numerous instruments have been developed to measure HRQoL, yet evidence of their cross-cultural equivalence and continued applicability is limited. We adapted the WHOQOL-HIV BREF to French and assessed its psychometric properties in a sample of community-dwelling adults living with HIV who were mostly virally suppressed.

METHODS

We conducted a cross-sectional study within the ANRS CO3 Aquitaine cohort from July 2018 to May 2019. Five hundred eighty-six participants were consecutively enrolled at their HIV-consultations and completed either a web-based (n = 406) or paper self-administered assessment (n = 180). The means and standard deviations for items and domains were computed and the presence of floor and ceiling effects assessed. We evaluated internal consistency by calculating Cronbach's alpha coefficients per domain. We assessed construct validity by performing a Confirmatory Factor Analysis (CFA). Concurrent, convergent and discriminant validity were assessed with Pearson's correlations and known-group validity was assessed according to CD4 cell count, viral load, Centers for Disease Control and Prevention clinical categories for HIV, and hospitalization of more than 48 h within 2 years of the most recent consultation using one-way analysis of variance and independent t-tests.

RESULTS

Five hundred eighty-six PLWH were included in this analysis. Their median age was 55; 73% were male; 85% were of French descent; 99% were on ART and 93% were virally suppressed. We found floor effects for one and ceiling effects for 11 items. Four of the six domains showed good internal consistency (α range: 0.63-0.79). CFA showed that the WHOQOL-HIV BREF's six-domain structure produced an acceptable fit (SRMR = 0.059; CFI = 0.834; RMSEA = 0.07; 90% CI: 0.06-0.08). It showed good concurrent, convergent and discriminant validity. There was some evidence of known-group validity. The personal beliefs domain had the highest score (15.04 ± 3.35) and the psychological health domain had the lowest (13.70 ± 2.78).

CONCLUSIONS

The French WHOQOL-HIV BREF has acceptable measurement properties. Its broad conceptualisation of HRQoL, going beyond physical and mental health, may be of particular value in our older, treatment-experienced and virally suppressed population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03296202 (Archived by WebCite at http://www.webcitation.org/6zgOBArps ).

Quality of Life People Living with HIV/AIDS and Its Characteristic from a VCT Centre in Indonesia

Background

The quality of life (QoL) construct has also contributed to understanding the comprehension of factors involved in the existence of people infected by the HIV/AIDS. The objective of this study is to assess the quality of life (QoL) of people with HIV/AIDS (PLWHA) in Wonogiri District, Indonesia.

Methods

A cross-sectional study was conducted from September to November 2017. Convenience sampling method was employed to recruit 39 people living with HIV/AIDS (PLWHA) at Voluntary Counselling and Testing (VCT) of Wonogiri, Indonesia. Research data were collected using a self-administered questionnaire of WHOQOL-HIV BREF. The data were further analysed using a t-test and a Chi-square test, while linear regression was used to evaluate factors that correlate with the PLWHAs' quality of life.

Results

The results showed that the gross mean score of social relationships domain is 13.59; psychological domain is 13.31; environment domain is 13.28; spiritual/personal beliefs domainis 13.15; physical domain is 13.10; and level of independence domain is 13.77. The symptom of HIV is associated with quality of life (B = 7.611, β = 0.362, t = 2,046, p value = 0.049).

Conclusion

Healthcare provider should increase providerinitiated testing and counselling (PITC) to contracting group, high risk group, susceptible group, and the community. The PLWHA are recommended to actively participate in peer support groups (PSGs) so that they can improve their quality of life.

Health related quality of life of HIV/AIDS patients on highly active anti-retroviral therapy at a university referral hospital in Ethiopia

BACKGROUND

Highly active antiretroviral therapy improves the longevity of patients living with HIV/AIDS. We conducted the study in order to assess health related quality of life of HIV/AIDS patients and the association of socio-demographic and disease related variables with health related quality of life.

METHODS

Health facility based cross-sectional study among 400 HIV/AIDS patients taking highly active anti-retroviral therapy from Gondar University referral hospital was conducted. A pre-tested semi-structured questionnaire, which was adopted from World Health Organization Quality of life brief instrument, was used. The data were then analyzed using SPSS version 20 software for Windows.

RESULTS

The majority of the respondents reported to to have a good physical health (15.55). The World Health Organization clinical stage was found to be significantly associated with all the domains of health related quality of life. The current acute illness condition of the respondents, however, did not show significant association with any of the domains of health related quality of life.

CONCLUSIONS

The six domains of health related quality of life were found to be moderate. The physical health and spirituality of the patients were relatively higher than their social relationship. Sex, age, educational status, residence and marital status showed significant association with at least one domain of health related quality of life.

Psychometric properties of the Chinese version of the WHOQOL-HIV BREF to assess quality of life among people living with HIV/AIDS: a cross-sectional study

OBJECTIVES

This study aims to assess the psychometric properties of the Chinese version of the WHOQOL-HIV BREF.

DESIGN

Cross-sectional study.

SETTING

Centers for Disease Control and Prevention and infectious disease hospitals in three Chinese provinces.

PARTICIPANTS

Sample of 1100 people living with HIV/AIDS (PLWHA).

INTERVENTIONS

We recruited 1100 PLWHA to evaluate their quality of life (QOL) using the WHOQOL-HIV BREF. Of these participants, 57 were randomly selected to repeat the QOL evaluation 2 weeks later.

MAIN OUTCOME MEASURES

The reliability of the WHOQOL-HIV BREF was assessed in terms of its internal consistency and test-retest reliability. The construct, concurrent, convergent, discriminant and known-group validity were also analysed. In addition, the factorial invariance across genders was assessed.

RESULTS

Cronbach's α coefficient for the overall scale was 0.93. Except for the spirituality domain, which had an α below 0.70 (0.66), the other five domains showed adequate internal consistency. The test-retest reliability revealed a statistically significant intraclass correlation coefficient of 0.72-0.82 (p<0.001). Confirmatory factor analysis found that the six-domain structure produced an acceptable fit to the data. The instrument showed factorial invariance across gender groups. All domains were significantly correlated with the general items and the SF-36 (p<0.01). The correlation coefficients were >0.40 (r=0.40-0.67), except for the association between the spirituality domain and two general items (QOL: r=0.33; health status: r=0.36). Subjects with lower CD4 counts had lower scores for all domains (p<0.05). Symptomatic participants had significantly lower scores than asymptomatic participants on the physical, psychological and independence domains (p<0.05).

CONCLUSIONS

The WHOQOL-HIV BREF revealed good psychometric characteristics among Chinese PLWHA. These findings offer promising support for the use of the WHOQOL-HIV BREF as a measure of QOL among Chinese PLWHA and in cross-cultural comparative studies on QOL.

An evaluation of quality of life among Cambodian adults living with HIV/AIDS and using antiretroviral therapy: a short report

The aim of this study was to evaluate quality of life (QOL) and analyze its determinants among Cambodian adults living with HIV/AIDS who are on antiretroviral therapy (ART). A cross-sectional study was conducted using convenience sampling to select 150 adults 18 years of age or older from the patient population at the HIV/AIDS care hospital in Phnom Penh, Cambodia. QOL was assessed using the World Health Organization Quality of Life HIV BREF; socio-demographic characteristics, time elapsed since HIV diagnosis, months on ART, CD4 cell count, family and community support, depression, and anxiety were included in the survey. Results of the multiple regression analysis indicate that positive predictors of QOL included being female, being less 40 years old, having a household monthly income greater than 300 USD, having an education beyond the secondary level, or being employed. However, time elapsed since HIV diagnosis and duration of ART were not significantly associated with QOL and CD4 cell count and the World Health Organization clinical stage had little association with QOL. Perceiving oneself as healthy and happy and reporting no depression or anxiety were associated with a positive QOL. These findings suggest the importance of group-specific interventions to improve the QOL for those people living with HIV/AIDS in Cambodia who are male, have a low household income or education level, are unemployed, or are anxious or depressed.

Factors Influencing Quality of Life among People Living with HIV in Coastal South India

BACKGROUND

Antiretroviral therapy (ART) has increased life expectancy of HIV/AIDS patients, but the quality of life (QOL) still remains the same.

METHODS

In this cross-sectional study, 356 people living with HIV (PLHIV) were interviewed to assess their QOL using WHOQOL-HIV BREF questionnaire. The association between QOL with sociodemographic, clinical and cohabitation status of the participants was tested using ANOVA and Student t-test, and p value < .05 was considered statistically significant.

RESULTS

Physical domain of QOL showed maximum score of 16.4, while a minimum score of 12.2 was seen in social relationship domain. Participants with higher socioeconomic status (SES) and self-motivated to take ART had shown better scores across all the domains of QOL ( p < .05).

CONCLUSION

In our study, quality of life was high among males, younger patients, married participants, higher socioeconomic status, longer duration of ART, self-motivation to take ART, absence of opportunistic infection, and with higher CD₄ count.