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Health-related quality of life in veterans and nonveterans with HIV/AIDS

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Abstract

Purpose

To compare health-related quality of life (HRQoL) between patients receiving care in Veterans Administration (VA) settings (veterans) and non-VA settings (nonveterans), and to explore determinants of HRQoL and change in HRQoL over time in subjects living with HIV/AIDS.

Subjects

One hundred veterans and 350 nonveterans with HIV/AIDS from 2 VA and 2 university-based sites in 3 cities interviewed in 2002 to 2003 and again 12 to 18 months later.

Methods

We assessed health status (functional status and symptom bother), health ratings, and health values (time tradeoff [TTO] and standard gamble [SG] utilities). We also explored bivariate and multivariable associations of HRQoL measures with a number of demographic, clinical, spiritual/religious, and psychosocial characteristics.

Results

Compared with nonveterans, the veteran population was older (47.7 vs 42.0 years) and consisted of a higher proportion of males (97% vs 83%), of participants with a history of injection drug use (23% vs 15%), and of subjects with unstable housing situations (14% vs 6%; P<.05 for all comparisons). On scales ranging from 0 (worst) to 100 (best), veterans reported significantly poorer overall function (mean [SD]; 65.9 [17.2] vs 71.9 [16.8]); lower rating scale scores (67.6 [21.7] vs 73.5 [21.0]), lower TTO values (75.7 [37.4] vs 89.0 [23.2]), and lower SG values (75.0 [35.8] vs 83.2 [28.3]) than nonveterans (P<.05 for all comparisons); however, in multivariable models, veteran status was only a significant determinant of SG and TTO values at baseline. Among other determinants that were associated with multiple HRQoL outcomes in baseline and follow-up multivariable analyses were: symptom bother, overall function, religiosity/spirituality, depressive symptoms, and financial worries.

Conclusions

Veterans reported significantly poorer HRQoL than nonveterans, but when controlling for other factors, veteran status was only a significant determinant of TTO and SG health values at baseline. Correlates of HRQoL such as symptom bother, spirituality/religiosity, and depressive symptoms could be fruitful potential targets for interventions to improve HRQoL in patients with HIV/AIDS.

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Authors and Affiliations

  1. Cincinnati VA Medical Center, Cincinnatl, OH, USA

    Joseph M. Mrus & Joel Tsevat

  2. University of Cinoinnati, Cincinnati, OH, USA

    Joseph M. Mrus, Anthony C. Leonard, Michael S. Yi, Susan N. Sherman & Joel Tsevat

  3. VA Connecticut Healthcare System, West Haven, CT, USA

    Shawn L. Fultz & Amy C. Justice

  4. Yale University School of Medicine, New Haven, CT, USA

    Shawn L. Fultz & Amy C. Justice

Authors
  1. Joseph M. Mrus
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  2. Anthony C. Leonard
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  3. Michael S. Yi
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  4. Susan N. Sherman
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  5. Shawn L. Fultz
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  6. Amy C. Justice
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  7. Joel Tsevat
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Correspondence to Joseph M. Mrus.

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Mrus, J.M., Leonard, A.C., Yi, M.S. et al. Health-related quality of life in veterans and nonveterans with HIV/AIDS. J GEN INTERN MED 21 (Suppl 5), S39–S47 (2006). https://doi.org/10.1111/j.1525-1497.2006.00644.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00644.x

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