Gender and Mental Health Aspects of Living with HIV Disease and Its Longer-Term Outcomes for UK Heterosexual Patients

Abstract

Gender is important in the experience of illness generally and HIV specifically. In this study the authors compare 183 HIV positive women with 76 HIV positive heterosexual men attending United Kingdom HIV clinics on clinical, treatment, and mental health factors. Participants completed a questionnaire on mental health and HIV-related factors. Laboratory measures of HIV viral load and CD4 cell count were obtained at baseline and 6–18 months later. After adjusting for age, employment, and treatment status, men were significantly less likely than women to suffer from high psychological [adjusted odds ratio (OR) = 0.38, 95% confidence interval (CI): 0.17, 0.86] and global symptom distress (adjusted OR = 0.42, 95% CI: 0.19, 0.92). However, men were more likely than women to report having suicidal thoughts (adjusted OR = 1.85, 95% CI: 0.95, 3.58). Relational, sexual behavior, and quality of life factors were similar for men and women. Adherence levels did not differ by gender but were sub-optimal in 56% of patients. Men had significantly lower CD4 counts than women at baseline, but not at follow-up. No differences were observed in the proportions with viral suppression. The groups had generally similar HIV experiences with high psychological distress. Adherence monitoring and gender appropriate psychological support are needed for these groups.

KEYWORDS:

• gender differences
• HIV/AIDS
• mental health

Notes

The authors wish to acknowledge all support, including GSK for an unrestricted educational grant in relation to the baseline data.

Note. ^#Denominators vary due to missing values.

*Fisher's exact test used.

$Unprotected sex with discordant/unknown status partner.

¹These analyses were conducted on patients currently on treatment only.

²Variable refers to the frequency of occurrence of such thoughts or feelings among patients who reported experiencing them.

³Clinical measures of viral load and CD4 count were only available for a subgroup of patients.

Note. ^#Denominators vary due to missing values.

*Medians presented with IQR.

¹These analyses were conducted on patients currently on treatment only.

²Variable refers to the frequency of occurrence of such thoughts or feelings among patients who reported experiencing them.

³Scores ranged from −0.32 to 0.92.

⁴Clinical measures of CD4 count were only available for a subgroup of patients.

⁺MWU test carried out.

Note. ¹Variable refers to the frequency of occurrence of such thoughts or feelings among patients who reported experiencing them.

²These analyses were conducted on patients currently on treatment only.

³Laboratory measures were only available for a subgroup of patients.

⁴These analyses were also adjusted for baseline CD4 count or viral load.

⁵Among patients having ever been on ART. Only individual psychological symptom variables significant at p < .15 in univariable analyses are included in this table. For dichotomous outcomes, the first category is the one to be predicted.

*Medians, interquartile range (IQR) and MWU tests results are reported.

⁺Means, standard deviations and t-test results are reported because the variable is normally distributed.