Health-related quality of life assessment among people living with HIV in Rio de Janeiro, Brazil: a cross-sectional study
To assess health-related quality of life (HRQoL) and its associated factors among people living with HIV/AIDS (PLWHA) in Rio de Janeiro, Brazil.
A cross-sectional study including PLWHA receiving usual HIV-care at Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz) was conducted between 2014 and 2016 in Rio de Janeiro, Brazil. The EQ-5D-3L assessed HRQoL; PHQ-2 and ASSIST were used for screening depression and substance use, respectively. Clinical variables were obtained from the INI/Fiocruz cohort database, and structured questions evaluated intimate partner violence, sexual abstinence and relationship status. Data were analysed using multivariable Tobit regression model.
A total of 1480 PLWHA were included: 64.7% were male at birth (38.4% men who have sex with men [MSM], 24.3% heterosexual men and 2% transgender women [TGW]); median age was 43.1 years, and 95.8% were receiving antiretroviral therapy. The median EQ-5D-3L utility score was 0.801. Results showed that the following factors: MSM and women; older age; lower educational level; no engagement in a relationship; depression screening positive; polysubstance use; and, detectable viral load were independently associated with worse HRQoL.
PLWHA under care at INI/Fiocruz presented good HRQoL. Polysubstance use, depression and lower educational level were among the factors negatively associated with HRQoL. This was the first time that the EQ-5D-3L utility scores were calculated for a considerable number of PLWHA in Brazil, which is a fundamental piece of information for future cost-effectiveness analysis.
KeywordsQuality of life Gender Age factors Educational status Depression Substance abuse Viral load, HIV
We would like to thank: first the research participants; the nurses Denise Arruda and Giselle Cardoso; all the working team at INI/Fiocruz cohort database, with special mention to Monica Derrico, Mauro Derrico, Flaviana Pavan, Mario Sergio Pereira, Andre Augusto and Ronaldo Moreira. We acknowledge the following funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)—Grant Numbers: 476024/2013-7 and 476333/2013-0; Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)—Newton Fund RCUK-CONFAP Research Partnerships call, Grant Number: E-26/170.021/2015; and, Programa Institucional de Bolsas de Iniciação Científica (PIBIC/CNPq).
RC, RBDB, PML, LV, SWC, MSO, RKF, BG and VGV reviewed the study protocol and contributed to its final version. RC did the statistical analysis. All authors contributed to the interpretation the results. RC wrote the first draft of the manuscript, which was revised by RBDB, PML, AML, RKF and BG. All authors contributed to the final version of the manuscript.
This study was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)—Grant Numbers: 476024/2013-7 and 476333/2013-0; Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Newton Fund RCUK-CONFAP Research Partnerships call, Grant Number: E-26/170.021/2015; and, Programa Institucional de Bolsas de Iniciação Científica (PIBIC/CNPq). These funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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