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Long-Term HIV Infection and Health-Related Quality of Life

October 21, 2014

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Additional Factors

The study team also found that HIV-positive people with the following factors were more likely to have reduced HRQoL compared to HIV-negative people:

  • people of colour
  • women (compared to straight men)


Changes With Time

When researchers checked the year when people became HIV positive with their HRQoL score, they noticed that there was a clear trend: The further back in time someone was infected, the more likely that they experienced poor HRQoL in the present era. Further analyses found that this was not merely due to an effect related to the age of participants. That is, there was no evidence that as HIV-positive people aged they experienced worse HRQoL compared to HIV-negative people. Additional analyses are needed to understand why some people who were diagnosed in the pre-HAART era are more likely to have worse HRQoL today than people diagnosed in the recent era. The researchers plan to assess differences between participants who never experienced AIDS-related illness and those who had in order to determine if this made a difference in HRQoL.


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Why the Differences?

The present analyses of ASTRA and HSE are cross-sectional in nature. Such an analysis or study design is analogous to a snapshot taken at one point in time. In such analyses, drawing firm conclusions between cause and effect is difficult. However, it is possible to place the ASTRA and HSE findings in context as we do in the following paragraphs.


Issues

Since the onset of the AIDS pandemic, mental health and emotional issues have been areas of concern for both HIV-positive and HIV-negative people. American physician Richard Glass, who observed the impact of the arrival of the HIV pandemic, proposed that "the intensity of emotional responses to AIDS may be at least partially due to its linkage with two of life's most powerful experiences -- sex and death." In the early era of AIDS, there was no effective treatment.

However, in the current era, with the near-normal life span projected for some HIV-positive people taking ART in high-income countries, fears about imminent death should not be prominent. Thus, there may be other reasons in the present study that account for why anxiety and depression are occurring in some HIV-positive people in high-income countries. The British researchers put forth the following possible explanations as to why participants in ASTRA tended to have reduced HRQoL:

  • living with a chronic condition
  • social circumstances
  • relationship issues
  • prejudice and discrimination that they may face
  • potential side effects of specific medicines

The researchers noted that regardless of the underlying cause(s) of anxiety and/or depression in HIV-positive people, their findings underscore the need for doctors and nurses to screen their patients for mental health and emotional issues and offer treatment (or referral to a specialist) if needed.

The present analysis also echoes a finding from many other studies: Depression and/or anxiety are issues faced by HIV-positive people in many regions, even in the current era. Undiagnosed, untreated or poorly managed mental health issues can not only affect HRQoL but a person's ability to adhere to ART and, in some cases, their survival.

The findings from the ASTRA and HSE comparisons are important. They demonstrate the need for HRQoL assessments to be done in other studies with HIV-positive people so that they can enjoy the benefits of ART and maximize their HRQoL.


Resources

HIV and Emotional Wellness -- CATIE's guide to how people with HIV can cultivate their emotional well-being

Canadian Mental Health Association

Mental health: Fighting the stigma -- Ministère de la Santé et des Services sociaux, Québec

Strengthening the aging brain -- TreatmentUpdate 203

Good for the brain -- advice from neuroscientists -- TreatmentUpdate 203

HIV and brain-related issues -- TreatmentUpdate 204

Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis


References

  1. Lopes M, Olfson M, Rabkin J, et al. Gender, HIV status, and psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry. 2012 Mar;73(3):384-91.
  2. Altman LK. Rare cancer seen in 41 homosexuals. The New York Times. 3 July, 1982. Available at: http://tinyurl.com/3hutf4w [Subscription or registration may be required]
  3. Clendinen D. AIDS spread pain and fear among ill and healthy alike. The New York Times. 17 June, 1983. Available at: http://tinyurl.com/pb29u85 [Subscription or registration may be required]
  4. Herman R. A disease's spread provokes anxiety. The New York Times. 8 August, 1982. Available at: http://tinyurl.com/ptnhuxu [Subscription or registration may be required]
  5. Henig RM. AIDS -- A new disease's deadly odyssey. The New York Times. 3 February 1983. Available at: http://tinyurl.com/ouygglu [Subscription or registration may be required]
  6. Anonymous. San Francisco seeks to combat fear of AIDS. The New York Times. 22 May, 1983. Available at: http://tinyurl.com/nva7829 [Subscription or registration may be required]
  7. Norman M. Homosexuals confronting a time of change. The New York Times. 16 June 1983. Available at: http://tinyurl.com/ptr2n8o [Subscription or registration may be required]
  8. Anonymous. The fear of AIDS. The New York Times. 25 June 1983. Available at: http://tinyurl.com/p7zcxcx [Subscription or registration may be required]
  9. Marzuk PM, Tierney H, Tardiff K, et al. Increased risk of suicide in persons with AIDS. JAMA. 1988 Mar 4;259(9):1333-7.
  10. Glass RM. AIDS and suicide. JAMA. 1988 Mar 4;259(9):1369-70.
  11. McManus H, Petoumenos K, Franic T, et al. Determinants of suicide and accidental or violent death in the Australian HIV Observational Database. PLoS One. 2014 Feb 19;9(2):e89089.
  12. Pompili M, Pennica A, Serafini G, et al. Depression and affective temperaments are associated with poor health-related quality of life in patients with HIV infection. Journal of Psychiatric Practice. 2013 Mar;19(2):109-17.
  13. Weber R, Ruppik M, Rickenbach M, et al. Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study. HIV Medicine. 2013 Apr;14(4):195-207.
  14. Low-Beer S, Chan K, Yip B, et al. Depressive symptoms decline among persons on HIV protease inhibitors. Journal of Acquired Immune Deficiency Syndromes. 2000 Apr 1;23(4):295-301.
  15. Robertson K, Bayon C, Molina JM, et al. Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada. AIDS Care. 2014 Jul 16:1-7.
  16. Do AN, Rosenberg ES, Sullivan PS, et al. Excess burden of depression among HIV-infected persons receiving medical care in the United States: data from the medical monitoring project and the behavioral risk factor surveillance system. PLoS One. 2014 Mar 24;9(3):e92842.
  17. Madsen LW, Fabricius T, Hjerrild S, et al. Depressive symptoms are frequent among drug users, but not associated with hepatitis C infection. Scandinavian Journal of Infectious Diseases. 2014 Aug;46(8):566-72.
  18. Aljassem K, Raboud JM, Hart TA, et al. Gender differences in severity and correlates of depression symptoms in people living with HIV in Ontario, Canada. Journal of the International Association of Physicians in AIDS Care. 2014; in press.
  19. Halkitis PN, Perez-Figueroa RE, Carreiro T, et al. Psychosocial burdens negatively impact HIV antiretroviral adherence in gay, bisexual, and other men who have sex with men aged 50 and older. AIDS Care. 2014 Nov;26(11):1426-34.
  20. Miners A, Phillips A, Kreif N, et al. Health-related quality-of-life of people with HIV in the era of combination antiretroviral treatment: a cross sectional comparison with the general population. Lancet HIV. 2014. Oct; 1(1): e32-40.
  21. Lohse N, Hansen AB, Pedersen G, et al. Survival of persons with and without HIV infection in Denmark, 1995-2005. Annals of Internal Medicine. 2007 Jan 16;146(2):87-95.
  22. Samji H, Cescon A, Hogg RS, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One. 2013 Dec 18;8(12):e81355.
  23. May MT, Gompels M, Delpech V, et al. Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy. AIDS. 2014 May 15;28(8):1193-202.
  24. Lohse N, Gerstoft J, Kronborg G, et al. Comorbidity acquired before HIV diagnosis and mortality in persons infected and uninfected with HIV: a Danish population-based cohort study. Journal of Acquired Immune Deficiency Syndromes. 2011 Aug 1;57(4):334-9.
  25. Hansen AB, Lohse N, Gerstoft J, et al. Cause-specific excess mortality in siblings of patients co-infected with HIV and hepatitis C virus. PLoS One. 2007 Aug 15;2(8):e738.
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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication CATIE News. Visit CATIE's Web site to find out more about their activities, publications and services.
 

 

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