Determinants of Health Related Quality of Life in HIV-Positive Patients on Antiretroviral Therapy

Abstract

Background The introduction of antiretroviral therapy (ART) has made HIV/AIDS a chronic disease rather than a deadly one and hence the need for Health Related Quality of Life Assessment (HRQoL). Due to the increase in the prevalence of HIV/AIDS in the Greater Accra Region, there has been the need to carry out this study to assess health related quality of life and its determinants among infected persons in the region. Objectives The main objective of the study was to assess factors that influence HRQoL. Therefore, HRQoL was measured among patients and associations between sociodemographic factors, adherence to medication, psychological factors and HRQoL were evaluated. Method Three hundred and seventy- six (376) HIV positive patients receiving care at the Greater Accra Regional Hospital were randomly sampled and interviewed using a four (4) sectioned questionnaire. The questionnaire consisted of socio- demographic data, the World Health Organization Quality of Life- Human Immunodeficiency Virus Bref (WHOQoL- HIV Bref), the Simplified Medication Adherence Questionnaire (SMAQ) and Hospital Anxiety and Depression (HAD) scales. Data collected was entered into Statistical Package for Social Sciences (SPSS) software version 20 and exported into Stata version 15. Analysis was done using means, standard deviation, percentages, frequencies, and associations determined by using ANOVA, Pearson’s chi squared test and multivariate regression analysis. Results Mean domain scores were highest for spiritual, religious and personal belief domain reporting the highest domain score (14.84±3.62) and social domain reporting the lowest domain score (12.24±3.08). Additionally, 61.70% (232) reported good overall quality of life. Based on multilinear regression analysis between determinants and domain scores and overall quality of life, anxiety and depression were the most dominant factors that had association with all the domains and overall quality of life at a p-value of <0.001. Abnormal levels of anxiety and depression showed much decreased domain scores as compared with normal level of anxiety and depression. Conclusion Overall quality of life for majority of HIV positive patients at Ridge Hospital was good. Counseling should also be intensified for infected patients on improving their social relationships. Much attention has to be devoted to assessing anxiety and depression among PLWHA for prompt assessment.