Functional Status and Overall Quality of Life in a Multiethnic HIV-Positive Population

The current study examines the numerous sociodemographic and behavioral variables associated with quality of life among multiethnic, economically disadvantaged HIV/AIDS patients. The researchers collected data in fall 2000 from 348 patients visiting the Thomas Street Clinic of the Harris County Hospital District in Houston, Texas. Participants filled out a questionnaire that elicited demographic variables including age, gender, ethnicity, education level, marital status, work status and HIV risk category. Disease severity variables included latest CD4 cell counts, nadir CD4 cell counts and AIDS status. The survey also assessed behavioral variables such as alcohol abuse and smoking as well as current illicit drug use.

The majority of participants had a high school education or less. Approximately one-third worked full- or part-time, while more than half (54 percent) were disabled due to health-related problems. Forty-nine percent of the sample answered yes to the question, "Do you have AIDS?" Forty-seven percent of participants reported current smoking on some or most days, 16 percent reported drinking five or more alcoholic beverages on at least one occasion during the previous 30 days, and 22 percent reported using an illicit drug at least once during the previous 30 days.

Analysis revealed that overall quality of life and work-related functioning were impaired in this patient population, results that held for every social, demographic and behavioral subgroup examined. The authors found that ethnic minorities and those with a lower education levels reported poorer work-role functioning, suggesting the potential presence of a social gradient even among this uniformly disadvantaged population with equal access to quality HIV/AIDS care.

Except for current illicit drug use, the researchers found that the behavioral variables they assessed did not have the hypothesized effect on functional status. "Several of the significant relationships observed in the current study were not hypothesized and have not been reported by others," the scientists wrote. "White patients with HIV/AIDS reported significantly poorer mental function than did black participants. Also, the finding that current smokers had significantly fewer psychological work-role limitations was not expected. ... Future efforts will be needed to assess the true nature of these relationships." The report's findings suggest that the influence of social inequality persists even among members of a universally disadvantaged population.