Symptom prevalence, burden and correlates among people living with HIV in Vietnam: a two-centre self-report study

Figures & data

Table 1. Sample characteristics (N = 567).

Variables
Age (years) Median (IQR)	36 (32-41)
	n (%)
Gender: (female)	207 (36.6)
Area of residence
Rural area	191 (33.7)
Urban area	376 (66.3)
Highest education level
No education	5 (0.9)
Primary school	63 (11.1)
Secondary school	195 (34.4)
High school	206 (36.3)
University / College	98 (16.2)
Marital status
Single	143 (25.2)
Married	313 (55.2)
Living with a partner	11 (1.9)
Separated	9 (1.6)
Divorced	33 (5.8)
Widowed	58 (10.2)
Household size (person)
Median (IQR)	4 (3-4)
Caring for children	364 (64.2)
Numbers of children as dependants (person)
Median (IQR)	1 (1-2)
Average income per month (n,%)
Less than 1.5 million VND	174 (30.7)
1.5 to 2.5 million VND	101 (17.8)
More than 2.5 to 3.5 million VND	89 (15.7)
More than 3.5 million VND	180 (31.7)
In paid employment	242 (42.7)
Place of care (n,%)
• Inpatient	103 (18.1)
• Outpatient	392 (69.1)
• Home	73 (12.8)
In stable relationship with partner	337 (59.4)
Functional status (ECOG)
0	378 (66.7)
1	137 (24.2)
2	31 (5.5)
3	18 (3.2)
4	1 (0.2)
HIV WHO clinical stage
Stage 1	381 (67.2)
Stage 2	49 (8.6)
Stage 3	53 (9.3)
Stage 4	56 (9.9)
CD4 count (cells) mm^3 Median (IQR)	349 (200 - 506)
Prior AIDS diagnosis	193 (34)
Receiving ART	539 (95.1)
Disclosure of HIV status to another	471 (83.1)
Unprotected sex with a partner of unknown HIV status in previous 3 months	33 (5.8)
IV drug injection the last 3 months	23 (4.1)
Sharing needles – among participants using IV drug for the last 3 months	10 (1.4)
Receiving methadone maintenance treatment	35 (6.2)

Table 2. Physical symptom prevalence and burden using MSAS-SF N = 567.

Rank	Physical symptoms	Prevalence N = 567 n (%)	Level of Distress (Burdensomeness)
			Not at all n (%)	A little bit n (%)	Somewhat n (%)	Quite a bit n (%)	Very much n (%)
1	Lack of energy	229 (40.4)	20 (3.5)	86 (15.2)	55 (9.7)	47 (8.3)	21 (3.7)
2	Drowsy	212 (37.4)	32 (5.6)	87 (15.3)	45 (7.9)	36 (3.6)	13 (2.3)
3	Lack of sleep	200 (35.3)	17 (3)	63 (11.1)	47 (8.3)	54 (9.5)	19 (3.4)
4	Numbness / Tingling	198 (35)	27 (4.8)	91(16)	36 (6.3)	38 (6.7)	7 (1.2)
5	Dry mouth	178 (31.4)	29 (5.1)	91 (16)	27 (4.8)	25 (4.4)	6 (1.1)
6	Cough	168 (29.6)	25 (4.4)	76 (13.4)	33 (5.8)	27 (4.8)	7 (1.2)
7	Hair loss	167 (29.5)	36 (6.3)	83 (14.6)	15 (2.6)	28 (4.9)	6 (1.1)
8	Dizziness	166 (29.2)	17 (3)	69 (12.2)	42 (7.4)	27 (4.8)	10 (1.8)
9	Lack of appetite	162 (28.6)	23 (4.1)	55 (9.7)	29 (5.1)	36 (6.3)	19 (3.4)
10	Lack of concentration	151 (26.6)	22 (3.9)	54 (9.5)	29 (5.1)	38 (6.7)	8 (1.4)
11	Weight loss	150 (26.5)	25 (4.4)	62 (10.9)	27 (4.8)	27 (4.8)	9 (1.6)
12	Pain	143 (25.2)	11 (1.9)	49 (8.6)	28 (4.9)	41 (7.2)	15 (2.6)
13	Change in skin	134 (23.6)	16 (2.8)	50 (8.8)	27 (4.8)	34 (6)	7 (1.2)
14	Sweating	125 (22.1)	21 (3.7)	59 (10.4)	22 (3.9)	21 (3.7)	2 (0.4)
15	Itching	115 (20.2)	3 (0.5)	52 (9.2)	27 (4.8)	26 (4.6)	6 (1.1)
16	Change in food taste	104 (18.4)	11 (1.9)	43 (7.6)	23 (4.1)	21 (3.7)	6 (1.1)
17	Nausea	101 (17.8)	6 (1.1)	51 (9)	24 (4.2)	13 (2.3)	7 (1.2)
18	I don’t look like myself	99 (17.5)	14 (2.5)	34 (6)	17 (3)	27 (4.8)	7 (1.2)
19	Feeling bloated	89 (15.7)	5 (0.9)	33 (5.8)	29 (5.1)	17 (3)	5 (0.9)
20	Diarrhea	86 (15.2)	9 (1.6)	38 (6.7)	18 (3.2)	13 (2.3)	8 (1.4)
21	Sexual problems	81 (14.3)	18 (3.2)	35 (6.2)	19 (3.4)	6 (1.1)	2 (0.4)
22	Constipation	79 (13.9)	10 (1.8)	37 (6.5)	12 (2.1)	16 (2.8)	4 (0.7)
23	Dyspnea	78 (13.7)	0 (0)	48 (8.5)	14 (2.5)	13 (2.3)	2 (0.4)
24	Urination symptoms	62 (11)	11 (1.9)	22 (3.9)	15 (2.6)	11 (1.9)	4 (0.7)
25	Vomiting	60 (10.5)	5 (0.9)	26 (4.6)	9 (1.6)	14 (2.5)	5 (0.9)
26	Mouth sore	57 (10)	3 (0.5)	23 (4.1)	12 (2.1)	15 (2.6)	4 (0.7)
27	Difficulty swallowing	54 (9.5)	2 (0.4)	22 (3.9)	14 (2.5)	14 (2.5)	1 (0.2)
28	Swelling arms/legs	32 (5.6)	3 (0.5)	12 (2.1)	8 (1.4)	6 (1.1)	2 (0.5)
Rank	Psychological symptoms	Prevalence	Frequency
			Rarely n (%)	Occasionally n (%)	Frequently n (%)	Almost constant n (%)
1	Worrying	235 (41.4)	32 (5.6)	115 (20.3)	76 (13.4)	12 (2.1)
2	Feeling nervous	229 (40.3)	36 (6.3)	142 (25)	42 (7.4)	9 (1.6)
3	Feeling irritable	172 (30.3)	27 (4.8)	104 (18.3)	36 (6.3)	5 (0.9)
4	Feeling sad	222 (39.1)	36 (6.3)	110 (19.4)	65 (11.5)	11 (1.9)

Table 3. MSAS-SF scores of HIV/AIDS patients (N = 567).

	Mean	Median	SD	IQR
Total MSAS score	0.51	0.33	0.50	0.11; 0.78
Physical distress subscale	0.53	0.27	0.61	0.07; 0.8
Psychological distress subscale	0.79	0.50	0.83	0.83; 1.33
GDI	0.71	0.50	0.69	0.16; 1.23
Number of symptoms	7.66	6	6.21	3; 12

Table 4. Associations of factors with symptoms in HIV/AIDS patients: univariate linear regression, N = 567.

Variables		Model 1: GDI	Model 2: PHYS	Model 3: PSYCH	Model 4: No Sx
Age	B	-0.005	2.153	21.236	0.979
	p	0.616	0.042 *	0.999	0.159 *
Gender	B	-0.101	0.143	-0.111	0.024
	p	0.566	0.416	0.525	0.893
Living location	B	0.49	0.118	0.504	0.168
	p	0.006 *	0.51	0.005 *	0.348
Education	B	-0.178	-0.266	-0.128	-0.106
	p	0.293	0.119 *	0.449	0.53
Having paid job	B	-0.023	-0.168	0.108	-0.259
	p	0.893	0.328	0.528	0.129 *
Average income	B	0.638	0.488	0.628	0.703
	p	0.001 *	0.009 *	0.001 *	0.0001 *
Marital status	B	0.163	0.212	0.091	0.19
	p	0.338	0.214 *	0.593	0.264
Having children	B	0.011	0.023	-0.099	0.063
	p	0.95	0.897	0.577	0.723
Place of care	B	-1.608	-1.965	-0.837	-1.757
	p	0.0001 *	0.0001 *	0.0001 *	0.0001 *
ECOG performance	B	-2.346	-2.641	-1.367	-2.786
	p	0.0001 *	0.0001 *	0.0001 *	0.0001 *
Prior diagnosis of AIDS	B	0.665	1.063	0.363	0.953
	p	0.0001 *	0.0001 *	0.044 *	0.0001 *
WHO clinical stage	B	-1.147	-1.497	-0.789	-1.552
	p	0.0001 *	0.0001 *	0.0001 *	0.0001 *
ART	B	-2.184	-1.639	-0.773	-1.452
	p	0.0001 *	0.001 *	0.062 *	0.004 *
CD4 count	B	0.523	0.825	0.285	0.697
	p	0.003 *	0.0001 *	0.105 *	0.0001 *
Drug injection in the last 3 months	B	0.849	1.382	1.071	1.196
	p	0.066 *	0.007 *	0.026 *	0.02 *
Disclosure HIV status	B	0.371	0.401	0.269	0.226
	p	0.101 *	0.078 *	0.232 *	0.024 *

*: p values < 0.25, included in regression models.

B: regression coefficient.

p: significance value.

Table 5. Associations of factors with symptom burden, multiple linear regression analysis N = 567.

	Model 1: GDI N1 = 488			Model 2: PHYS N = 478			Model 3: PSYCH N = 493			Model 4: Number of Symptom N = 482
	B	p	OR (CI 95%)	B	p	OR (CI 95%)	B	P	OR (CI 95%)	B	p	OR (CI 95%)
Age (Older adult (> = 60) = reference group)	N/A	N/A	N/A	1.897	0.08	6.668 (0.798; 7.33)	N/A	N/A	N/A	0.723	0.325	2.061 (0.488; 8.712)
Living location (Urban = reference group)	0.353	0.091	1.424 (0.945; 2.144)	N/A	N/A	N/A	0.404	0.046 *	1.498 (1.006; 2.231)	N/A	N/A	N/A
Education (High school or higher education = reference group)	N/A	N/A	N/A	-0.478	0.027 *	0.620 (0.405; 0.948)	N/A	N/A	N/A	N/A	N/A	N/A
Having paid job (No = reference group)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	-0.018	0.936	0.982 (0.634; 1.523)
Average income per month (Not below poverty line = reference group)	0.613	0.004 **	1.847 (1.222; 2.791)	0.73	0.001 ***	2.075 (1.332; 3.235)	0.588	0.004 **	1.8 (1.204; 2.691)	0.773	0.001 ***	2.167 (1.354; 3.467)
Relationship status (Having partner = reference group)	N/A	N/A	N/A	0.128	0.535	1.137 (0.758; 1.704)	N/A	N/A	N/A	N/A	N/A	N/A
Place of care (Inpatient = reference group)	-0.563	0.172	0.569 (0.254; 1.278)	-0.924	0.038 *	0.397 (0.166; 0.951)	-0.251	0.533	0.778 (0.353; 1.715)	-0.719	0.117	0.487 (0.199; 1.197)
ECOG performance group (Low function = reference group)	-1.002	0.117	0.367 (0.105; 1.287)	-1.446	0.079	0.236 (0.047; 1.182)	-0.97	0.089	0.379 (0.124; 1.158)	-2.158	0.047 *	0.116 (0.014; 0.969)
Prior diagnosis of AIDS (No = reference group)	0.315	0.191	1.37 (0.855; 2.196)	0.566	0.022 *	1.762 (1.085; 2.862)	-0.19	0.936	0.981 (0.615; 1.566)	0.357	0.147	1.43 (0.882; 2.318)
WHO clinical stage (Stage 3-4 = reference group)	-0.445	0.164	0.641 (0.342; 1.2)	-0.638	0.059	0.528 (0.272; 1.025)	-0.332	0.298	0.718 (0.384; 1.34)	-0.762	0.029 *	0.467 (0.235; 0.926)
ART (No = reference group)	-0.834	0.242	0.434 (0.107; 1.758)	-0.46	0.519	0.631 (0.156; 2.56)	-0.084	0.893	0.919 (0.27; 3.123)	0.399	0.573	1.49 (0.372; 5.974)
CD4 count (350 or more = reference group)	0.128	0.546	1.137 (0.75; 1.724)	0.263	0.231	1.301 (0.845; 2.003)	0.045	0.829	1.046 (0.696; 1.573)	0.251	0.242	1.285 (0.844; 1.957)
Drug injection in the last 3 months (No = reference group)	0.055	0.922	1.057 (0.351; 3.184)	0.318	0.602	1.374 (0.416; 4.538)	0.816	0.18	2.262 (0.687; 7.45)	0.342	0.592	1.407 (0.404; 4.902)
Disclosure HIV status (No = reference group)	0.403	0.134	1.497 (0.883; 2.539)	0.159	0.579	1.173 (0.668; 2.059)	0.21	0.411	1.234 (0.747; 2.037)	0.453	0.094	1.573 (0.925; 2.674)
Nagelkerke R square	0.128			0.218			0.085			0.189

*statistically significant at 5% level.

**statistically significant at 1% level.

***statistically significant at 0.1% level.

Data availability statement

Data are available from the corresponding author on reasonable request.