The Influence of Psychological Variables on Health-Related Quality of Life among HIV-Positive Individuals with a History of Intravenous Drug Use

Abstract

Objective: Intravenous drug use (IDU) remains a prominent pathway of HIV transmission in the United States, though little is known about modifiable factors influencing quality of life among IDUs. The goal of this study was to evaluate the influence of psychological variables (e.g., depression and anxiety) on health-related quality of life among HIV-positive individuals with a history of IDU who were enrolled in outpatient treatment for opioid dependence. Method: 108 HIV-positive individuals with a history of IDU and participating in current outpatient treatment for opiate dependence who were screened for participation in a depression and adherence study reported sociodemographic data, depressive and anxiety symptoms, and health-related quality of life (HRQoL; Multidimensional Health Assessment using the ACTG-SF 21). Results: Multiple regression models controlling for disease stage and background characteristics identified significant negative relationships between General Health Perception and Functioning without Pain for anxiety and depression, and between Role Functioning and Physical Functioning for anxiety. CD4 cell count was significantly related to Physical Functioning only. Conclusions: Results indicate that distress (both depression and anxiety) contribute significantly to variation in HRQoL over and above the effects of disease variables. Effective depression and anxiety treatment may result in improved overall functioning.

Keywords:

• anxiety
• depression
• health-related quality of life
• HIV
• intravenous drug use

Acknowledgments

Data collection for this project was funded by grant number DA018603 (Safren) from the National Institute of Drug Abuse. Some of the investigator time (SAS) was supported by grant number 1K24MH094214 and (CP) grant number 1K23MH096651.