Health-related quality of life in HIV/AIDS patients on antiretroviral therapy at a tertiary care facility in Zimbabwe

• Published in: AIDS care Vol. 28; no. 7; pp. 904 - 912
• Main Authors: Mafirakureva, N., Dzingirai, B., Postma, M.J., van Hulst, M., Khoza, S.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.07.2016; Taylor & Francis Ltd
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - diagnosis; Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - psychology; Activities of daily living; Adult; AIDS; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active - methods; Antiretroviral Therapy, Highly Active - psychology; Anxiety - diagnosis; Bioindicators; Biological markers; Biomarkers; Clinical outcomes; Construct validity; Convergence; Convergent validity; Cronbach's alpha; Cross-Sectional Studies; Disclosure; Drug therapy; Economic conditions; Employment; EQ-5d; Female; HAT-QoL; Health status; Health-related quality of life; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; HIV/AIDS; Human immunodeficiency virus; Humans; Intervention; Male; Measurement; Medical treatment; Middle Aged; Monitoring instruments; Pain Measurement; Patient Outcome Assessment; Patients; Quality of Life; Reliability; Reliability analysis; Reproducibility of Results; Research Design; Sexually transmitted diseases; Social factors; Socioeconomic factors; STD; Surveys and Questionnaires; Tertiary Healthcare - methods; Tertiary Healthcare - statistics & numerical data; Therapy; Zimbabwe; Zimbabwe - epidemiology; Zimbabwe; HIV/AIDS; EQ-5d; Health-related quality of life; Zimbabwe; HAT-QoL; antiretroviral therapy
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2016.1173639

Health-related quality of life (HRQoL) is a broad concept reflecting a patient's general subjective perception of the effect of an illness or intervention on physical, psychological and social aspects of their daily life. HRQoL among patients infected with HIV has become an important indicator of impact of disease and treatment outcomes. A cross-sectional survey was carried out at Chitungwiza Central Hospital, Zimbabwe, to assess HRQoL in patients with HIV/AIDS receiving antiretroviral therapy (ART), using two validated instruments. The HIV/AIDS-targeted quality of life (HAT-QoL) and EuroQoL Five-dimensions-Three-level (EQ-5D-3L) instruments were used to assess HRQoL. Internal consistency reliability and convergent validity of the two instruments were also evaluated. For construct validity, the relationships between HRQoL scores and socio-economic and HIV/AIDS-related characteristics were explored. The median scores for the HAT-QoL dimensions ranged from 33.3 (financial worries) to 100 (HIV mastery). A considerably low HAT-QoL dimension score of 50.0 was observed for sexual function. There were ceiling effects for all HAT-QoL dimension scores except for financial worries and disclosure worries. Floor effects were observed for financial worries and sexual function. The median of the EQ-5D-3L index and visual analogue scale (VAS) was 0.81 and 79.0, respectively. There were no floor or ceiling effects for both the EQ-5D-3L index and VAS. The overall scale Cronbach's alpha was 0.83 for HAT-Qol and 0.67 for EQ-5D-3L. HAT-QoL demonstrated good convergent validity with EQ-5D index (0.58) and VAS (0.40). A higher level of HRQoL was positively and significantly related to income, education and employment. The patients' self-reported HRQoL was generally satisfactory in all the HAT-QoL dimensions as well as the two components on the EQ-5D-3L instrument. The two instruments demonstrated good measurement properties in HIV/AIDS patients receiving ART and have potential for use, alongside biomarkers, in monitoring outcomes of interventions.