Quality of Life of People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study in Monastir, Tunisia

Figures & data

Table 1 WHO Quality of Life HIV-Bref Instrument

	Domain 1	Domain 2	Domain 3	Domain 4	Domain 5	Domain 6	Q1		Q2
Type	Physical	Psychological	Level of independence	Social/Relations	Environmental	Spiritual/Religious/beliefs	Overall QoL/General health perception
Questions (Qs)	Q3, Q4, Q14, Q21	Q6, Q11, Q15, Q24, Q31	Q5, Q20, Q22, Q23	Q17, Q25, Q26, Q27	Q12, Q13, Q16, Q18, Q19, Q28, Q29, Q30	Q7, Q8, Q9, Q10
Reverse & recode negative phrased items		Q3, Q4, Q5, Q8, 9, 10, Q31		1=5, 2=4, 3=3, 4=2, 5=1
Compute	Sum of Qs/4x4	Sum Qs/5x4	Sum of Qs/4x4	Sum of Qs/4x4	Sum of Qs/8x4	Sum of Qs/4x4
Results
Lowest score	4	4	4	4	4	4	1
Highest score	20	20	20	20	20	20	5

Note: Data from World Health Organization.²¹

Table 2 People Living with HIV Personal Data and Clinical Determinants (n = 105)

Variables	Number	Percentage %	Mean (SD)
Sex
Male	78	74.3
Female	27	25.7
Age /years			39.20±10.18
<40	61	58.09
≥40	44	41.91
Education level
None	4	3.8
Primary education	26	24.8
Secondary education	39	37.1
University	37	34.3
Marital status
Single	43	41
Married	42	40
Divorced	13	12.2
Widowed	7	6.8
Residence area
Urban	75	71.4
Rural	30	28.6
Habitation
Owner	35	33.4
Tenant	41	39
Others	29	27.6
Profession
Yes	49	46.7
No	56	53.3
Attending psychologist
Yes	18	17.1
No	87	82.9
Health status
Very poor	3	2.9
Poor	7	6.7
Neither poor not good	58	55.2
Good	28	26.7
Very good	9	8.5
Person informed about HIV status
None	18	17.2
Family	41	39
Friend	46	43.8
HIV status
Asymptomatic	95	90.6
Symptomatic	10	9.4
Feel ill
Yes	40	61.9
No	65	38.1
CD4 count			618.72±291.56
<500mm^3	34	38.6
≥500	54	61.4
HIV duration			10.28±7.77
≤10 years	61	58.1
>10 years	44	41.9
ART duration
≤10 years	78	74.3	7.95±5.65
> 10 years	27	25.7
HIV transmission
Sex with a man	42	40
Sex with a woman	38	36.2
Injecting drugs	12	11.4
Blood/products	3	2.9
Others	10	9.5

Table 3 Means and SD of Quality of Life Domains

QoL Domains	Physical	Psychological	Level of Independence	Social Relations	Environmental	Spiritual	Q1	Q2
Min	4	4	4	4	5,5	4
Max	20	20	19	20	20	20
Mean	14.11	12.76	13.98	12.58	12.34	14.05	3	3.41
SD	3.52	3.31	3.57	3.94	2.90	3.78	0.92	1.08

Abbreviations: Min, minimum; Max, maximum; Q1, overall QoL; Q2, general health perception.

Table 4 Mean Differences in QoL Domains Using Independent t-Test in PLHIV (n = 105)

QoL Domains/Variables	Physical	Psychological	Level of Independence	Social Relations	Environmental	Spiritual
Sex
Male	14.15	12.91	14.03	12.62	12.35	14.03
Female	14	12.32	13.81	12.48	12.33	14.11
p. value	0.84	0.34	0.78	0.88	0.97	0.92
Age
<40 years	14.01	12.55	13.72	12.72	12.31	13.57
≥40 years	14.25	13.05	14.34	12.39	12.39	14.70
p. value	0.73	0.44	0.38	0.67	0.88	0.13
Profession
Yes	14.87	13.37	14.73	13.21	13.17	14.43
No	13.24	12.05	13.12	11.86	11.39	13.61
p. value	0.01*	0.04*	0.02*	0.07	0.000**	0.27
Residence area
Urban	14.09	12.81	14.20	12.36	12.32	13.87
Rural	14.16	12.64	13.43	13.13	12.41	14.50
p. value	0.92	0.81	0.32	0.36	0.87	0.44
HIV duration
≤10 years	14.32	12.85	14.11	12.57	12.32	13.77
>10 years	13.81	12.63	13.79	12.59	12.37	14.43
p. value	0.46	0.74	0.65	0.98	0.93	0.37
ART duration
≤10 years	14.10	12.78	14.02	12.42	12.39	13.94
>10 years	14.14	12.69	13.85	13.04	12.20	14.37
p. value	0.95	0.90	0.82	0.48	0.76	0.61
HIV status
Asymptomatic	14.17	12.84	14.08	12.65	12.26	14.18
Symptomatic	13.63	12.07	13.09	12	13.09	12.91
p. value	0.63	0.46	0.38	0.60	0.37	0.29
Feel ill
Yes	12	11.26	12.67	11.43	11.35	12.63
No	15.41	13.66	14.78	13.29	12.96	14.92
p. value	0.000**	0.000**	0.003**	0.01*	0.005**	0.002**
CD4 count
<500mm^3	14.41	12.98	14.26	12.47	12.60	14.82
≥500mm^3	13.88	12.65	13.63	12.48	11.85	13.72
p. value	0.49	0.64	0.43	0.99	0.24	0.18
Psychologist
Yes	14	12.93	14.16	12.11	12.69	14.06
No	14.13	12.72	13.49	12.68	12.27	14.05
p. value	0.13	0.81	0.81	0.58	0.58	0.99

Notes: *Significant; **strongly significant.

Table 5 Mean Differences in QoL Domains in PLHIV Using One-Way ANOVA (n = 105)

QoL Domains/Variables	Physical	Psychological	Level of Independence	Social Relations	Environmental	Spiritual
Education level
None	^a–	–	–	–	–	–
Primary	12.46	11.90	12.38	11.27	11.25	13.78
Secondary	14.38	12.93	13.71	12.72	12.01	13.81
University	14.86	13.21	15.21	13.25	13.47	14.28
p. value	0.002**	0.28	0.006**	0.13	0.008**	0.82
Marital status
Single	14.26	12.83	14.74	12.21	12.86	13.70
Married	14.65	13.11	13.81	13.50	12.19	15.07
Divorced	11.69	10.86	11.92	10.54	10.65	12.23
Widowed	^b–	–	–	–	–	–
p. value	0.02*	0.10	0.04*	0.04*	0.05*	0.04*
Habitation
Owner	14.14	13.22	13.97	12.51	13.04	14.26
Tenant	14.07	12.28	13.80	12	11.73	13.44
Others	14.13	12.88	14.24	13.48	12.37	14.66
p. value	0.99	0.45	0.88	0.30	0.14	0.38
Health status
Very poor/poor	8.20	9.16	9.10	7.08	9.00	10.40
Neither poor not good	13.91	12.54	13.51	12.52	11.99	14.21
Good/very good	16.02	14.07	16.02	13.97	13.81	14.78
p. value	0.000**	0.000**	0.000**	0.000**	0.000**	0.004**
Informed Person
None	13.05	12.44	12.44	11.28	10.38	13.22
Family member	14.65	13.35	14.26	13.39	13.04	15.07
Friend	14.04	12.43	14.32	12.37	12.48	13.46
p. value	0.27	0.33	0.13	0.14	0.004**	0.08
HIV transmission
Sex with a man	14.21	12.70	14.00	12.38	12.78	13.69
Sex with a woman	13.78	12.67	13.63	12.18	11.96	14.45
Injecting drugs	13.91	12.33	14.75	12	11.75	12.42
Others	14.92	13.60	14.23	14.92	12.61	15.54 0.16
p. value	0.78	0.78	0.81	0.14	0.52

Notes: ^a,bNot included, *significant, **strongly significant.

Table 6 Multiple Linear Regression Analysis

Models	Variables	Coefficient	Standard Error	t	P-value	Adjusted R-Squared
Physical	Constant	7.02	1.36	5.16	0.000	0.30
	Education level	–0.04	0.36	–0.11	0.91
	Marital status	-0.39	0.32	–1.21	0.22
	Profession	0.68	0.61	1.11	0.26
	Feel ill	–0.47	0.63	–5.41	0.000**
	Informed person	0.05	0.41	0.57	0.56
	Health status	2.277	0.368	6.19	0.000**
Psychological	Constant	8.24	1.42	5.77	0.000	0.13
	Education level	–0.04	0.37	–0.87	0.38
	Marital status	-0.30	0.34	-0.87	0.38
	Profession	0.72	0.64	1.12	0.26
	Feel ill	–0.35	0.62	–3.87	0.000**
	Informed person	-0.02	0.41	-0.31	0.75
	Health status	1.43	0.38	3.73	0.000**
Level of independence	Constant	6.87	1.44	4.76	0.000	0.24
	Education level	0.30	0.38	0.79	0.42
	Marital status	–0.20	0.34	–0.57	0.56
	Profession	0.64	0.64	0.99	0.32
	Feel ill	–0.28	0.68	–3.04	0.003**
	Informed person	0.15	0.45	1.64	0.10
	Health status	1.96	0.39	5.05	0.000**
Social relations	Constant	8.15	1.71	4.76	0.000	0.12
	Education level	0.05	0.45	0.11	0.90
	Marital status	–0.69	0.41	-1.68	0.09
	Profession	0.59	0.76	0.76	0.44
	Feel ill	–0.23	0.77	–2.38	0.019*
	Informed person	0.04	0.51	0.42	0.66
	Health status	1.59	0.46	3.45	0.001**
Environment	Constant	6.83	1.19	5.73	0.000	0.21
	Education level	0.27	0.31	0.88	0.37
	Marital status	0.01	0.28	0.05	0.95
	Profession	1.12	0.53	2.10	0.038*
	Feel ill	–0.26	0.55	–2.85	0.005**
	Informed person	0.18	0.36	1.95	0.054*
	Health status	1.30	0.32	4.05	0.000**
Spiritual	Constant	12.13	1.64	7.36	0.000	0.11
	Education level	–0.73	0.43	–1.67	0.09
	Marital status	-0.91	0.39	-2.31	0.023*
	Profession	0.45	0.73	0.61	0.54
	Feel ill	–0.29	0.73	–3.14	0.002**
	Informed person	-0.04	0.48	-0.50	0.61
	Health status	1.46	0.44	3.29	0.000**

Notes: *Significant; **strongly significant.

World Health Organization. WHOQOL-HIV BREF. Department of mental health and substance dependence, CH-1211 Geneva 27, Switzerland; 2002. Available from: https://www.who.int/mental_health/media/en/613.pdf. Accessed October 31, 2023.

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