Skip to main content
SpringerLink
Log in

Stress and Health–Related Quality of Life Among HIV-Infected Persons in Hong Kong

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

This study examines the relationships among illness-related factors, stress, health-related quality of life (HRQOL), and psychological distress in persons infected with the human immunodeficiency virus (HIV) living in Hong Kong (N = 55). Participants completed questionnaires including a Symptom Checklist, Modified HIV Stressor Scale (HIVSS), Medical Outcomes Study Short-Form 36 (SF-36), and the Hospital Anxiety and Depression Scale (HADS). In addition, CD4 count information was obtained. Multiple regression analyses were used to model the SF-36 and HADS scores as a function of illness-related factors as well as the stress count and intensity. The number of symptoms was found to be inversely related to SF-36 general health and positively related to the HADS anxiety score. However, CD4 count did not have any significant association with any of the scales on the HRQOL or psychological distress. After controlling for the effect of symptoms, the HIVSS stress count still accounted significantly for additional variance in both HADS anxiety and depression as well as the SF-36 social functioning and role-emotional scores. The study supports the possible contribution of psychosocial factors to the HRQOL and psychological distress after controlling for illness-related factors. Results are discussed in the context of characteristic social factors and services in Hong Kong.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bastardo, Y. M., and Kimberlin, C. L. (2000). Relationship between quality of life, social support and disease-related factors in HIV-infected persons in Venezuela. AIDS Care, 12, 673-684.

    Google Scholar 

  • Bing, E. G., Hays, R. D., Jacobson, L. P., Chen, B., Gange, S. J., Kass, N. E., Chmiel, J. S., and Zucconi, S. L. (2000). Health-related quality of life among people with HIV disease: Results from the multicenter AIDS cohort study. Quality of Life Research, 9, 55-63.

    Google Scholar 

  • Catalan, J., Meadows, J., and Douzens, A. (2000). The changing pattern of mental health problems in HIV infection: The view from London, UK. AIDS Care, 12, 333-341.

    Google Scholar 

  • Catz, S. L., McClure, J. B., Jones, G. N., and Brantley, P. J. (1999). Predictors of outpatient medical appointment attendance among persons with HIV. AIDS Care, 11, 361-373.

    Google Scholar 

  • Centers for Disease Control and Prevention. (1996). 1993 revised classification system for HIV-1 infection and expanded surveillance case definition for AIDS among adolescents and adults. Available at: http://WWW.cdc.gov/hiv/

  • Centres for Disease Control and Prevention. (1997). HIV/AIDS surveillance report (Vol. 9, No. 1). Atlanta, GA: U.S. Department of Health and Human Services.

    Google Scholar 

  • Centres for Disease Control and Prevention. (2001). Revised guidelines for HIV counseling, testing and referral. Atlanta, GA: U.S. Department of Health and Human Services.

    Google Scholar 

  • Cowdery, J. E., and Pesa, J. A. (2002). Assessing the quality of life in women living with HIV infection. AIDS Care, 14, 235-245.

    Google Scholar 

  • Crawford, A. M. (1996). Stigma associated with AIDS: A meta-analysis. Journal of Applied Social Psychology, 26, 398-416.

    Google Scholar 

  • Deeks, S. G., Smith, M., Holodiny, M., and Kahn, J. (1997). HIV-1 protease inhibitors. A review for clinicians. Journal of the American Medical Association, 277, 145-153.

    Google Scholar 

  • Eckenrode, J. (Ed.). (1992). The social context of coping. New York: Plenum Press.

    Google Scholar 

  • Fleishman, J. A., and Fogel, B. (1994). Coping and depressive symptoms among people with AIDS. Health Psychology, 13, 156-169.

    Google Scholar 

  • Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207-1221.

    Google Scholar 

  • Folkman, S., Chesney, M., Pollack, L., and Phillips, C. (1992). Stress, coping and high-risk sexual behavior. Health Psychology, 11, 218-222.

    Google Scholar 

  • Folkman, S., Chesney, M., and Christopher-Richards, A. (1994). Stress and coping in caregiving partners of men with AIDS. Psychiatric Clinics of North America, 1, 35-53.

    Google Scholar 

  • Franchi, D., and Wenzel, R. P. (1998). Measuring health-related quality of life among patients infected with human immunodeficiency virus. Clinical Infectious Diseases, 8, 20-26.

    Google Scholar 

  • Friedland, J., Renwick, R., and McColl, M. (1996). Coping and social support as determinants of quality of life in HIV/AIDS. AIDS Care, 8, 15-31.

    Google Scholar 

  • Globe, D. R., Hays, R. D., and Cunningham, W.E. (1999). Associations of clinical parameters with health-related quality of life in hospitalized persons with HIV disease. AIDS Care, 11, 71-86.

    Google Scholar 

  • Grusky, O., Liu, H., and Johnston, M. (2002). HIV/AIDS in China: 1990–2001. AIDS and Behavior, 6, 381-393.

    Google Scholar 

  • Heckman, T. G. (2003). The Chronic Illness Quality of Life (CIQOL) model: Explaining life satisfaction in people living with HIV disease. Health Psychology, 22, 140-147.

    Google Scholar 

  • Hedge, B. (1999). The impact of HIV infection on partners and relatives. In J. Catalan (Ed.), Mental health and HIV infection: Psychological and psychiatric aspects (pp. 66-89). London: UCL Press.

    Google Scholar 

  • Hong Kong Council of Social Services. (2003). HIV/AIDS statistics and service organizations in Hong Kong. Available at: http://drugaids.socialnet.org.hk/aids--stat--eng.htm

  • Hong Kong Department of Health, AIDS Unit. (1998). AIDS manual for nurses. Hong Kong: Author.

    Google Scholar 

  • Hong Kong Department of Health, HIV/AIDS Surveillance Office. (2002). HIV/AIDS statistics in Hong Kong. Hong Kong: Author.

    Google Scholar 

  • Kalichman, S. C., Sikkema, K. J., and Somlai, A. (1995). Assessing persons with human immunodeficiency virus (HIV) infection using the Beck Depression Inventory: Disease processes and other potential confounds. Journal of Personality Assessment, 64, 86-100.

    Google Scholar 

  • Kanner, A. D., Coyne, J. C., Schaeffer, C., and Lazarus, R. S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4, 1-39.

    Google Scholar 

  • Kemppainen, J. K. (2001). Predictors of quality of life in AIDS patients. Journal of the Association of Nurses in AIDS Care, 12(1), 2001, 61-70.

    Google Scholar 

  • Lam, C. L. K., Lauder, I. J., and Lam, T. P. (1999). Population based norming of the Chinese (HK) version of the SF-36 health survey. Hong Kong Practitioner, 21, 460-470.

    Google Scholar 

  • Lee, L. M., Karon, J. M., Selik, R., Neal, J. J., and Fleming, P. L. (2001). Survival after AIDS diagnosis in adolescents and adults during the treatment era, United States, 1984–1997. JAMA, 285, 1308-1315.

    Google Scholar 

  • Leung, C. M., Ho, S., Kan, C. S., Hung, C. H., and Chen, C. N. (1993). Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale. International Journal of Psychosomatics, 40, 29-34.

    Google Scholar 

  • Low-Beer, S., Chan, K., Wood, E., Yip, B., Montaner, J. S. G., and Shaughnessy, M. V. O. (2000). Health related quality of life among persons with HIV after the use of protease inhibitors. Quality of Life Research, 9, 941-49.

    Google Scholar 

  • Lubeck, D. P., and Fries, J. F. (1997). Assessment of quality of life in early stage HIV-infected persons. Data from the AIDS Time-Orientated Health Outcome Study (ATHOS). Quality of Life Research, 6, 494-506.

    Google Scholar 

  • Molassiotis, A., Callaghan, P., Twinn., S. F., and Lam., S. W. (2001). Assessment of needs of adult symptomatic HIV patients in Hong Kong. AIDS Care, 13, 177-189.

    Google Scholar 

  • Pakenham, K. I., and Rinaldis, M. (2001). The role of illness, resources, appraisal and coping strategies in adjustment to HIV/AIDS: The direct and buffering effects. Journal of Behavioral Medicine, 24, 259-279.

    Google Scholar 

  • Schmitz, M. F., and Crystal, S. (2000). Social relations, coping and psychological distress among persons with HIV/AIDS. Journal of Applied Social Psychology, 30, 665-685.

    Google Scholar 

  • Schonnesson, L. N. (2002). Psychological and existential issues and quality of life in people living with HIV infection. AIDS Care, 14, 399-404.

    Google Scholar 

  • Schwartz, M. (1996). Gay men and the health care system. In K. J., Peterson (Ed.), Health care for lesbians and gay men: Confronting homophobia and heterosexism (pp. 19-32). New York: Harrington Park Press/Haworth Press.

    Google Scholar 

  • Sowell, R. L., and Misener, T. R. (1997). Decisions to have a baby by HIV-infected women. Western Journal of Nursing, 19, 56-70.

    Google Scholar 

  • Sze, F., Wong, E., Lo, R., and Woo, J. (2000). Do pain and disability differ in depressed cancer patients? Palliative Medicine, 14, 11-17.

    Google Scholar 

  • Thompson, S. C., Nanni, C., and Levine, A. (1996). The stressors and stress of being HIV-positive. AIDS Care, 8, 5-14.

    Google Scholar 

  • Vassend, O., and Esklid, A. (1998). Psychological distress, coping and disease progression in HIV-positive homosexual men. Journal of Health Psychology, 3, 243-257.

    Google Scholar 

  • Vosvick, M., Gore-Felton, C., Koopman, C., Thoresen, C., Krumboltz, J., and Spiegel, D. (2002). Maladaptive coping strategies in relation to quality of life among HIV+ adults. AIDS and Behavior, 6, 97-106.

    Google Scholar 

  • Wachtel, T., Piette, J., Mor, V., Stein, M., Fleishman, J., and Carpenter, C. (1992). The Medical Outcomes Study: An application of methods for monitoring the results of medical care. Annals of Internal Medicine, 116, 129-137.

    Google Scholar 

  • Ware, J. E., and Sherbourne, C. D. (1992). The MOS 36-item short-form (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473-483.

    Google Scholar 

  • Wu, A. W., Revicki, D. A., Jacobson, D., and Malitz, F. E. (1997). Evidence for the reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Quality of Life Research, 6, 481-493.

    Google Scholar 

  • Zigmond, A. S., and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Psychology Service, Queen Elizabeth Hospital, Hong Kong, China

    Alma Au & Iris Chan

  2. Special Medical Service, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China

    Patrick Li, Rita Chung, Li Man Po & Pansy Yu

Authors
  1. Alma Au
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Iris Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rita Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li Man Po
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pansy Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alma Au.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Au, A., Chan, I., Li, P. et al. Stress and Health–Related Quality of Life Among HIV-Infected Persons in Hong Kong. AIDS Behav 8, 119–129 (2004). https://doi.org/10.1023/B:AIBE.0000030243.50415.c0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:AIBE.0000030243.50415.c0

Search

Navigation