Quality of life in people living with HIV in Romania and Spain

Meaghan Kall; Ujué Fresán; Danielle Guy; Graham Brown; Cristina Burgui; Jesús Castilla; Victor Ionel Grecu; Florentina Dumitrescu; Valerie Delpech; Jeffrey V Lazarus

doi:10.1186/s12879-021-06567-w

Quality of life in people living with HIV in Romania and Spain

BMC Infect Dis. 2021 Sep 13;21(Suppl 2):898. doi: 10.1186/s12879-021-06567-w.

Authors

Affiliations

¹ HIV/STI Department, Public Health England, London, NW9 5EQ, UK. Meaghan.Kall@phe.gov.uk.
² Instituto de Salud Pública de Navarra-IdiSNA-CIBERESP, Pamplona, Spain.
³ Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, S08036, Barcelona, Spain.
⁴ Centre for Social Impact, University of New South Wales, High Street, Sydney, Australia.
⁵ Spitalul Clinic de Boli Infectioase si Pneumoftiziologie "Victor Babes" Craiova, 200515, Craiova, Romania.
⁶ HIV/STI Department, Public Health England, London, NW9 5EQ, UK.

Abstract

Background: Health-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as HIV. The aim of the study was to examine and compare the health-related quality of life of people living with HIV in Romania and Spain, compared to the general populations of each country.

Methods: A cross-sectional survey was conducted among adults (≥ 18 years) attending for HIV care in Romania and Spain from October 2019 to March 2020. The survey included two validated HRQoL instruments: a generic instrument, EQ-5D-5L, and an HIV-specific instrument, PozQoL, and questions on socio-demographics, HIV-related characteristics, physical and mental health conditions, and substance use. Multivariable linear regression was used to determine factors associated with HRQoL.

Results: 570 people living with HIV responded (170 in Romania and 400 in Spain). The median age was 31 (18-67) in Romania and 52 (19-83) in Spain. Anxiety/depression symptoms were frequently reported by people with HIV (Romania: 50% vs 30% in the Romanian population; Spain: 38% vs 15% in Spanish population). Spain reported higher mean EQ-5D_utility scores than Romania (0.88 and 0.85, respectively) but identical PozQoL scores (3.5, on a scale of 0-5). In both countries, health concerns were highlighted as a key issue for people with HIV. In multivariable analysis, two factors were consistently associated with worse HRQoL in people with HIV: bad or very bad self-rated health status and presence of a mental health condition. In Romania, being gay/bisexual and being disabled/unemployed were associated with worse HRQoL. Whereas in Spain, older age and financial insecurity were significant predictors.

Conclusions: Our results indicated a good HRQoL for people living with HIV in Romania and Spain; however, worse HRQoL profiles were characterized by health concerns, poor self-rated health status, and the presence of mental health conditions. This study highlights the importance of monitoring HRQoL in people living with HIV due to the chronic nature of the disease. In this highly-treatment experienced group, disparities were found, particularly highlighting mental health as an area which needs more attention to improve the well-being of people living with HIV.

Keywords: Chronic diseases; EQ-5D; HIV/AIDS; Health-related quality of life; PozQoL; Romania; Spain.

MeSH terms

Adult
Aged
Cross-Sectional Studies
HIV Infections* / epidemiology
Humans
Quality of Life*
Romania / epidemiology
Spain / epidemiology

Grants and funding

761319/Executive Agency for Health and Consumers