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