Factors associated with quality of life in middle-aged and older patients living with HIV

Figures & data

Table 1. Sociodemographic and HIV-related characteristics of participants listed in percent.

	Total (N = 1194)	< 50 years (n = 1009)	≥50 years (n = 185)	<50 years vs. ≥50 years p^a	Cramer's V
Gender				.442	.02
Male	67.5	68.0	64.9
Female	32.5	32.0	35.1	0.226
Marital status				<.001	.27
Single	44.5	49.9	15.1
Married/co-habiting	33.5	30.3	50.8
Separated/divorced	18.1	16.9	24.3
Widowed	4.0	2.9	9.7
Employment status				.008	.08
Employed	50.2	51.8	41.1
Not currently working	49.8	48.2	58.9
Mode of transmission				<.001	.25
Sexual intercourse with man	35.0	34.5	38.0
Sexual intercourse with woman	27.2	24.2	43.5
IV Drug use	32.4	36.9	8.2
Blood products	3.0	2.2	7.1
Unknown	2.4	2.2	3.3
HIV stage				.088	.07
Asymptomatic	61.5	60.9	64.7
Symptomatic	12.7	12.0	16.3
AIDS	20.4	21.4	14.7
Unknown	5.5	5.7	4.3
CD4+ T cell count				.667	.03
<200 cells/mm^3	23.5	24.0	20.9
201 and 499 cells/mm^3	41.9	41.5	44.2
>500 cells/mm^3	34.6	34.5	35.0
cART				.112	.05
Yes	75.5	76.4	70.6
No	24.5	23.6	29.4
Other co-infections				<.001	.15
Yes	28.1	31.0	11.9
No	71.9	69.0	88.1
	M (SD)	M (SD)	M (SD)	P^b	Cohen's d
Age (years)	40.74 (9.69)	37.60 (6.26)	57.84 (6.79)	–	–
Education (years)	7.89 (4.11)	8.08 (3.99)	6.80 (4.58)	<.001	0.30
Time since HIV diagnosis (years)	8.06 (5.18)	8.37 (5.11)	6.34 (5.20)	<.001	0.39

^aχ² analysis.

^bStudent's t-test.

Table 2. Descriptive statistics on QoL domains and depressive symptoms (adjusted for covariates).^a

	<50 years (n = 1009)	≥50 years (n = 185)	F
	M (95% CI)	M (95% CI)
Quality of life^b
Physical	63.90 (62.58–65.22)	58.85 (55.67–62.04)	8.04**	.007
Psychological	59.99 (58.82–61.16)	57.73 (54.90–60.55)	2.07	.002
Level of independence	65.19 (63.88–66.49)	60.66 (57.51–63.81)	6.63*	.006
Social relationships	61.27 (60.03–62.51)	57.55 (54.57–60.59)	4.84*	.004
Environment	56.49 (55.58–57.39)	56.21 (54.03–58.38)	0.05	.000
Spirituality	59.62 (58.22–61.02)	58.32 (54.95–61.69)	0.48	.000
Overall QoL	53.54 (52.30–54.77)	51.63 (48.64–54.62)	1.31	.001
Depressive symptoms
Depression – cognitive	8.25 (7.78–8.72)	7.89 (6.75–9.03)	0.32	.000
Depression – somatic	5.77 (5.48–6.06)	7.05 (6.36–7.75)	10.90**	.009

^aMultivariate analysis of variance (MANOVA) adjusted for education, marital status, employment status, mode of HIV transmission, time since HIV diagnosis and presence of other co-infections.

^bA higher score corresponds to a better QoL.

*p < .05

**p < .01.

Table 3. Descriptive statistics on specific facets of the WHOQOL-HIV-Bref (adjusted for covariates).^a

	<50 years (n = 1009)	≥50 years (n = 185)	F
	M (95% CI)	M (95% CI)
Domain 1 – physical
Pain and discomfort	3.97 (3.89–4.04)	3.69 (3.52–3.87)	7.69*	.007
Energy and fatigue	3.38 (3.32–3.44)	3.17 (3.02–3.32)	6.53*	.006
Sleep and rest	3.21 (3.13–3.28)	3.08 (2.90–3.26)	1.46	.001
Symptoms of PLWHAs^b,c	3.67 (3.59–3.75)	3.47 (3.27–3.67)	3.28	.003
Domain 2 – psychological
Positive feelings	3.80 (3.74–3.86)	3.67 (3.52–3.83)	2.30	.002
Cognitions	3.26 (3.20–3.32)	3.29 (3.15–3.44)	0.19	.000
Body image and appearance	3.56 (3.49–3.63)	3.34 (3.18–3.51)	5.84*	.005
Self-esteem	3.46 (3.39–3.52)	3.31 (3.14–3.47)	2.68	.002
Negative feelings	2.92 (2.86–2.99)	2.93 (2.77–3.09)	0.01	.000
Domain 3 – level of independence
Mobility	3.83 (3.77–3.89)	3.58 (3.42–3.73)	8.90**	.008
Activities of daily living	3.51 (3.44–3.57)	3.33 (3.18–3.48)	4.47*	.004
Dependence on medication or treatment	3.75 (3.67–3.83)	3.53 (3.33–3.72)	4.47*	.004
Work capacity	3.35 (3.28–3.41)	3.29 (3.12–3.43)	0.61	.001
Domain 4 – social relationships
Personal relationships	3.56 (3.50–3.62)	3.43 (3.28–3.58)	2.33	.002
Social support	3.50 (3.44–3.56)	3.43 (3.28–3.58)	0.71	.001
Sexual activity	3.11 (3.04–3.18)	2.74 (2.57–2.90)	16.18***	.014
Social inclusion^b	3.63 (3.57–3.70)	3.62 (3.47–3.77)	0.03	.000
Domain 5 – environment
Physical safety and security	3.24 (3.18–3.30)	3.24 (3.10–3.38)	0.00	.000
Home environment	3.55 (3.49–3.62)	3.54 (3.39–3.69)	0.02	.000
Health and social care	3.67 (3.61–3.73)	3.60 (3.46–3.75)	0.63	.000
Financial resources	2.44 (2.38–2.51)	2.67 (2.52–2.81)	7.32**	.006
New information or skills	3.33 (3.27–3.39)	3.22 (3.08–3.36)	2.04	.002
Recreation and leisure	2.89 (2.82–2.95)	2.85 (2.69–3.01)	0.14	.000
Physical environments	3.37 (3.32–3.43)	3.34 (3.21–3.47)	0.18	.000
Transport	3.58 (3.53–3.64)	3.53 (3.38–3.67)	0.52	.000
Domain 6 – spirituality
Spirituality, Religion, Personal beliefs	3.55 (3.49–3.62)	3.43 (3.27–3.59)	1.67	.002
Forgiveness^b	3.65 (3.57–3.74)	3.65 (3.44–3.85)	0.08	.000
Fear of the future^b	2.97 (2.88–3.05)	2.95 (2.75–3.15)	0.16	.000
Death and dying^b	3.36 (3.27–3.46)	3.31 (3.09–3.52)	0.40	.000

^aMultivariate analysis of variance (MANOVA) adjusted for education, marital status, employment status, mode of HIV transmission, time since HIV diagnosis and presence of other co-infections.

^bItems from the HIV module.

^cPLWHA: People living with HIV/AIDS.

*p < .05.

**p < .01.

***p < .001.

Table 4. Hierarchical multiple regression analysis of the variables associated with QoL domains among middle-aged and older patients.

	Physical	Psychological	Independence	Social relationships	Environment	Spirituality
	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)
Gender	.06 (.456)	.07 (.387)	−.06 (.431)	−.01 (.927)	.10 (.211)	.10 (.222)
Marital status	.00 (.986)	.11 (.171)	.04 (.607)	.14 (.091)	.14 (.080)	.17 (.041)
Education (years)	.10 (.285)	.21 (.015)	.17 (.045)	.06 (.469)	.16 (.057)	.12 (.163)
Employment	.07 (.441)	.09 (.280)	.12 (.172)	.17 (.049)	.18 (.033)	.06 (.518)
Mode of transmission	−.09 (.316)	−.08 (.335)	−.05 (.542)	−.01 (.878)	−.05 (.530)	−.07 (.419)
Time since HIV diagnosis (years)	−.15 (.095)	−.15 (.074)	−.13 (.124)	−.13 (.137)	−.09 (.302)	−.12 (.169)
HIV stage	−.09 (.341)	−.02 (.795)	−.15 (.078)	.06 (.459)	.05 (.542)	.01 (.876)
CD4+ T cell count (cells/mm^3)	.09 (.318)	.05 (.562)	.09 (.294)	.11 (.203)	.03 (.707)	−.01 (.879)
cART	.12 (.202)	.20 (.025)	.25 (.005)	.17 (.054)	.16 (.061)	.10 (.285)
Other co-infections	.07 (.438)	.16 (.051)	.11 (.174)	.17 (.041)	−.04 (.668)	.14 (.095)
	R^2 = .075	R^2 = .145	R^2 = .155	R^2 = .127	R^2 = .150	R^2 = .093
Cognitive-affective depressive symptoms	−.28 (.006)	−.60 (<.001)	−.40 (<.001)	−.48 (<.001)	−.43 (<.001)	−.37 (<.001)
Somatic depressive symptoms	−.33 (.002)	−.05 (.601)	−.20 (.041)	−.16 (.097)	−.15 (.117)	−.14 (.211)
	ΔR^2 = .283	ΔR^2 = .377	ΔR^2 = .289	ΔR^2 = .340	ΔR^2 = .276	ΔR^2 = .211

Notes: Gender [0 = Female; 1 = Male]; Marital status [0 = Living alone; 1 = Living with partner]; Employment status [0 = Unemployed or not currently working; 1 = Employed]; HIV stage [0 = Asymptomatic; 1 = Symptomatic/AIDS]; Mode of transmission [0 = Sexual; 1 = Other]; cART [0 = No; 1 = Yes]; Other co-infections [0 = No; 1 = Yes].