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Health-related quality of life among people living with HIV in the era of universal test and treat: results from a cross-sectional study in KwaZulu-Natal, South Africa

Moyo, RC, Sigwadhi, LN, Carries, S, Mkhwanazi, Z, Bhana, A, Bruno, D, Davids, EL, Van Hout, MC and Govindasamy, D (2024) Health-related quality of life among people living with HIV in the era of universal test and treat: results from a cross-sectional study in KwaZulu-Natal, South Africa. HIV Research & Clinical Practice, 25 (1). ISSN 2578-7489

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Abstract

Background: The World Health Organization’s (WHO) key population-based strategy for ending the human immunodeficiency virus (HIV) epidemic is universal HIV test and treat (UTT) along with pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Despite the successful scale-up of the UTT strategy in sub-Saharan Africa, the quality of life (QoL) of people living with HIV (PLHIV) remains sub-optimal. Poor quality of life in PLHIV may threaten the UNAIDS 95-95-95 programme targets. Monitoring QoL of PLHIV has become a key focus of HIV research among other outcomes so as to understand health-related quality of life (HRQoL) profiles and identify interventions to improve programme performance. This study aimed to describe HRQoL profiles and identify their predictors in PLHIV in KwaZulu Natal, South Africa. Methods: We conducted a secondary data analysis of a cross-sectional survey conducted between May and June 2022 among PLHIV (n=105) accessing HIV services at an outpatient clinic in KwaZulu-Natal, South Africa. Socio-demographic, HRQoL (EQ-5D-5L index scores), clinical data, depressive symptoms (CES-D-10) and viral load data were collected from all participants. We examined predictors of HRQoL using generalised linear models controlling for age and sex. Results: The mean age of the participants was 45 years (SD= 13). The proportion of participants with disabilities and comorbidities was 3% and 18%, respectively. Depressive symptoms were present in 49% of the participants. Participant’s mean EQ-5D-5L index score was 0.87 (SD= 0.21) and ranged from 0.11 to 1.0. The mean general health state (EQ-VAS) was 74.7 (SD= 18.8) and ranged from 6 to 100. Factors that reduced HRQoL were disability (β=-0.607, p<0.001), comorbidities (β = - 0.23, p<0.05), presence of depressive symptoms (β = -0.10, p<0.05) and old age (β = -0.04, p<0.05). Factors that increased HRQoL were a good perceived health state (β = 0.147, p<0.001) and availability of social support (β = 0.098, p<0.05). Conclusion: A combination of old age (60 years and above), any disability and comorbidities had a considerable effect on HRQoL among PLHIV. Our findings support the recommendation for an additional fourth UNAIDS target that should focus on ensuring that 95% of PLHIV have the highest possible HRQoL. Psycho-social support interventions are recommended to improve the HRQoL of PLHIV.

Item Type: Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Psychology (from Sep 2019)
Public Health Institute
Publisher: Taylor and Francis Group
SWORD Depositor: A Symplectic
Date Deposited: 18 Dec 2023 14:48
Last Modified: 16 Jan 2024 10:00
DOI or ID number: 10.1080/25787489.2023.2298094
URI: https://researchonline.ljmu.ac.uk/id/eprint/22124
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