The benefits of care: treated HIV infection and health-related quality of life among older-aged people in Uganda

Lien T Quach; Christine S Ritchie; Alexander C Tsai; Zahra Reynolds; Robert Paul; Janet Seeley; Yao Tong; Susanne Hoeppner; Samson Okello; Noeline Nakasujja; Brianne Olivieri-Mui; Deanna Saylor; Meredith Greene; Stephen Asiimwe; Mark J Siedner

doi:10.1080/13607863.2022.2150143

The benefits of care: treated HIV infection and health-related quality of life among older-aged people in Uganda

Aging Ment Health. 2023 Sep-Oct;27(9):1853-1859. doi: 10.1080/13607863.2022.2150143. Epub 2022 Dec 12.

Authors

Lien T Quach^{1

2

3}, Christine S Ritchie^{2

4}, Alexander C Tsai^{5

6

7}, Zahra Reynolds¹, Robert Paul⁸, Janet Seeley⁹, Yao Tong¹, Susanne Hoeppner^{1

5}, Samson Okello^{7

10}, Noeline Nakasujja¹¹, Brianne Olivieri-Mui¹², Deanna Saylor¹³, Meredith Greene¹⁴, Stephen Asiimwe^{15

16

17}, Mark J Siedner^{1

5

7}

Affiliations

¹ Medical Practice Evaluation Center, Massachusetts General Hospital, MA, USA.
² Centre for Aging and Serious Illness, Massachusetts General Hospital, MA, USA.
³ Department of Gerontology, University of Massachusetts Boston, MA, USA.
⁴ Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, MA, USA.
⁵ Department of Medicine, Harvard Medical School, Harvard University, MA, USA.
⁶ Department of Psychiatry, Massachusetts General Hospital, MA, USA.
⁷ Faculty of Medicine, Mbarara University of Science and Technology in Mbarara, Uganda.
⁸ Missouri Institute of Mental Health University of Missouri - St Louis, MO, USA.
⁹ Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
¹⁰ Department of Epidemiology, University of North Carolina, NC, USA.
¹¹ Department of Psychiatry, the College of Health Sciences, Makerere University, Uganda.
¹² Department of Health Sciences, Northeastern University, MA, USA.
¹³ Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA.
¹⁴ Department of Medicine, University of California, San Francisco, USA.
¹⁵ Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda.
¹⁶ Kabwohe Clinical Research Center (KCRC), Kabwohe, Uganda.
¹⁷ Center for Global Health, Massachusetts General Hospital, MA, USA.

PMID: 36503332
PMCID: PMC10258228 (available on 2024-09-01)
DOI: 10.1080/13607863.2022.2150143

Abstract

Objectives: The objective of this study is to explore how HIV care affects health-related quality of life (HRQoL) among older people in Uganda.

Methods: We enrolled older-aged (≥49 years) people with HIV receiving HIV care and treatment, along with age- and sex-similar people without HIV. We measured health-related quality of life using the EQ-5D-3L scale.

Results: People with HIV (n = 298) and people without HIV (n = 302) were similar in median age (58.4 vs. 58.5 years), gender, and number of comorbidities. People with HIV had higher self-reported health status (b = 7.0; 95% confidence interval [CI], 4.2-9.7), higher EQ-5D utility index (b = 0.05; 95% CI, 0.02-0.07), and were more likely to report no problems with self-care (adjusted odds ratio [AOR], 2.0; 95% CI, 1.2-3.3) or pain/discomfort (AOR = 1.8, 95% CI, 1.3-2.8). Relationships between HIV serostatus and health-related quality of life differed by gender, but not age.

Conclusions: Older people with HIV receiving care and treatment reported higher health-related quality of life than people without HIV in Uganda. Access to primary care through HIV programs and/or social network mobilization may explain this difference, but further research is needed to elucidate the mechanisms.

Keywords: HIV; Uganda; anxiety and trauma related disorders; depression ; mood disorders; epidemiology (mental health); health service use; health-related quality of life; older people; quality of life/wellbeing; psychosocial and cultural aspects.

Abstract

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