The impact of HIV on maternal quality of life in Uganda

Abstract

To study the effect of HIV infection on quality of life (QOL) during pregnancy and puerperium, QOL was measured in a cohort study at St. Francis Hospital Nsambya, Kampala, Uganda. Dartmouth COOP charts were administered to 132 HIV-positive and 399 HIV-negative women at 36 weeks of pregnancy and six weeks post-partum. Responses were coded from 0 = best health-status to 4 = worst health-status and scores of 3–4 defined as poor. Odds ratios (OR) (95% confidence intervals(CI)) for poor scores were calculated and independent predictors of poor QOL examined using logistic regression. In pregnancy, HIV-positive women were more likely to have poor scores in feelings: OR = 3.2(1.9–5.3), daily activities: OR = 2.8(1.4–5.5), pain: OR = 2.1(1.3–3.5), overall health: OR = 1.7(1.1–2.7) and QOL: OR = 7.2(3.6–14.7), all p= ≤ 0.01. Differences in physical fitness, change in health, social activities and social support were not statistically significant (all p>0.2). HIV infection was independently associated with poor QOL: OR = 8.5(3.8–19). Findings in puerperium were similar to those in pregnancy except more HIV-positive women had poor scores in social activities: OR = 2.5(1.4–4.7) and change in health: OR = 5.4(2–14.5) and infant death also predicted poor QOL: OR = 6.7(2.4–18.5). The findings reflect HIV's adverse impact on maternal QOL and the need for interventions to alleviate this infection's social and emotional effects.

Acknowledgments

Many thanks to The Rhodes Trust which funded the first author's scholarship at the University of Oxford, the Public Health Research Fund Oxfordshire NHS Charitable Foundation for funding the fieldwork, the Ugandan research team A. Kiyingi, B.E. Mwebaze, H. Kalanzi and M. Mugenyi, the study participants and the administration of St. Francis Hospital Nsambya for their co-operation. Also gratefully acknowledged are the staff of the Department of Public Health, University of Oxford, Old Road Campus where the first author was based during this research.