Gender differences in health-related quality of life at the time of a positive HIV test – a cross-sectional study in a resource-poor, high prevalence setting in Nairobi, Kenya

ABSTRACT

Few studies have examined gender differences in sub-Saharan Africa, where HIV disproportionately affects women. Objectives of this cross-sectional study were to determine gender differences in HRQoL at the time of a positive HIV test, and whether factors associated with HRQoL differed between men and women. Adults testing HIV-positive were recruited from two clinics located in informal settlements. HRQoL was measured with the SF-12. Multiple linear regression was used to test whether there were gender differences in physical (PCS) and mental composite summary (MCS) scores. Separate models were built for men and women to examine factors associated with HRQoL. Between April 2013 and June 2015, 775 individuals from were recruited. The mean PCS score was higher in women (adjusted mean difference 2.49, 95% CI 0.54 to 4.44, p = 0.012). There was no significant gender difference in MCS scores. Similar factors were associated with better physical HRQoL in men and women: secondary education, younger age, higher CD4, and employment. Employment was the only factor associated with MCS in men, while less social support and low CD4 were associated with poorer MCS scores in women. Gender differences in factors related to HRQoL should be considered in broader policy and interventions to improve the HRQoL in those diagnosed with HIV.

KEYWORDS:

• HIV/AIDS
• sub-Saharan Africa
• gender
• health-related quality of life
• SF-12
• informal settlements

Acknowledgements

We would like to thank Richard Gichuki and Sarah Karanja for their dedicated work on the study; and all of the clinical staff, research team members, and patients who participated in the study. We are grateful to Michael Guo and Partick Boutet for scoring the SF-12 and to for helping prepare the manuscript. Finally, we would like to acknowledge Lawrence Gelmon in his contributions as an investigator.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under award number R01MH097558, awarded to the University of British Columbia, and the CIHR Canadian HIV Trials Network (CTN S284). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. MVDK was supported by a Canadian Institutes of Health Research (CIHR) Doctoral Award – Doctoral Foreign Study Award (October 2012), offered in partnership with the CIHR Strategy for Patient-Oriented Research and the CIHR HIV/AIDS Research Initiative.