Highly active antiretroviral treatment and health related quality of life in South African adults with human immunodeficiency virus infection: A cross-sectional analytical study
1 Department of Community Health, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
2 School of Medicine, Health Policy & Practice, University of East Anglia, Norwich NR4 7TJ, UK
3 Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
4 Department of Economics/Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
5 Knowledge Translation Unit, University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
6 Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
BMC Public Health 2007, 7:244 doi:10.1186/1471-2458-7-244Published: 14 September 2007
Health Related Quality of Life (HRQoL) is an important outcome in times of Highly Active Antiretroviral Treatment (HAART). We compared the HRQoL of HIV positive patients receiving HAART with those awaiting treatment in public sector facilities in the Free State province in South Africa.
A stratified random sample of 371 patients receiving or awaiting HAART were interviewed and the EuroQol-profile, EuroQol-index and Visual Analogue Scale (VAS) were compared. Independent associations between these outcomes and HAART, socio-demographic, clinical and health service variables were estimated using linear and ordinal logistic regression, adjusted for intra-clinic clustering of outcomes.
Patients receiving HAART reported better HRQoL for 3 of the 5 EuroQol-dimensions, for the VAS score and for the EuroQol index in bivariable analysis. They had a higher mean EuroQol index (0.11 difference, 95% confidence interval [CI] 0.04; 0.23), and were more likely to have a higher index (odds ratio 1.9, 95% CI 1.1; 1.3), compared to those awaiting HAART, in multivariate analysis. Higher mean VAS scores were reported for patients who were receiving HAART (6.5 difference, 95% CI 1.3; 11.7), were employed (9.1, 95% CI 4.3; 13.7) or were female (4.7, 95% CI 0.79; 8.5).
HAART was associated with improved HRQoL in patients enrolled in a public sector treatment program in South Africa. Our finding that the EuroQol instrument was sensitive to HAART supports its use in future evaluation of HIV/AIDS care in South Africa. Longitudinal studies are needed to evaluate changes in individuals' HRQoL.