HIV Symptom Clusters are Similar Using the Dimensions of Symptom Occurrence and Distress

• Published in: Journal of pain and symptom management Vol. 63; no. 6; pp. 943 - 952
• Main Authors: Wilson, Natalie L., Hoffman, Thomas J., Heath, Sonya L., Saag, Michael S., Miaskowski, Christine
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; AIDS; Antineoplastic Agents - therapeutic use; Antiretroviral drugs; Antiretroviral therapy; Body image; Clinical research; Clustering; Comorbidity; distress; Exploratory factor analysis; Factor Analysis, Statistical; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Symptom Index; Human immunodeficiency virus; Humans; Multiple symptoms; occurrence; Pain; Pain - drug therapy; Pain - epidemiology; Psychological distress; Self image; symptom clusters; Symptoms; Syndrome; symptom clusters; distress; HIV Symptom Index; HIV; exploratory factor analysis; occurrence; Symptoms
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2022.02.337

People living with HIV infection (PLWH) in the United States continue to experience a high symptom burden despite improvements in antiretroviral therapy. The purpose of this study was to determine if the number and types of symptom clusters differed based on whether symptom occurrence rates or distress ratings were used to create the clusters. Data from 2,000 patients with complete symptom occurrence rates and distress scores on the 20-item HIV Symptom Index from their first ambulatory clinic visit at one of six national HIV centers of excellence in the Center for AIDS Research Network of Integrated Clinical Systems were used in these analyses. Exploratory factor analysis was used to create the symptom clusters. The same four symptom clusters (i.e., gastrointestinal, psychological, pain, body image) were identified using occurrence rates and distress ratings. For both dimensions of the symptom experience, the psychological, pain, and body image clusters each had the same symptoms. For the gastrointestinal cluster, four symptoms loaded on the occurrence dimension and six symptoms loaded on the distress dimension. The number and types of symptom clusters were relatively similar across the occurrence and distress dimensions of the symptom experience. Symptom clusters in PLWH may provide insights into the development of targeted interventions for multiple co-occurring symptoms.