Quality of life of people living with HIV/AIDS in Finland

Nuno M. Ribeiro Nobre

Forskningsoutput: AvhandlingDoktorsavhandlingSamling av artiklar

Sammanfattning

The purpose of this study is to explore the factors influencing the QoL of PLWHIV in Finland and to compare it with the QoL of Portuguese PLWHIV, of the general population, and of patients with other chronic diseases (asthma, diabetes, and arthritis), and thus to provide healthcare professionals with tools to identify individuals most at risk for impaired QoL. Finnish data were collected by self-administered questionnaires (WHOQOL-HIV-BREF, 15D and our own questionnaire) and from patients’ electronic medical records. Individuals were recruited from four different sites (Infectious Disease Clinic of Helsinki University Hospital, Hivpoint, Hiv Finland, and Helsinki Deaconess Institute). All the engaged participants received care and were followed up in the Infectious Disease Clinic of Helsinki University Hospital. In Study I, the properties of the Finnish version of the WHOQOL-HIV-BREF were explored by comparing the results obtained with the Finnish WHOQOL-HIV-BREF version with those obtained with the generic 15D instrument. In Study II, the QoL of PLWHIV was compared in Finnish and in Portuguese PLWHIV. This comparison was based on the results obtained with the WHOQOL-HIV-BREF instrument. Study III explored the influence of sociodemographic and HIV-related variables on the QoL, measured by the WHOQOL-HIV-BREF, of PLWHIV in Finland. Study IV assessed HIV-related self-stigma and the impact of self-stigma on health-related QoL (HRQoL) of the Finnish PLWHIV measured both by the WHOQOL-HIV-BREF and the 15D instruments. In Study V, the HRQoL of PLWHIV in Finland was compared with that of the general population and of patients with other chronic diseases (asthma, diabetes, and arthritis); in that study, the HRQoL was measured with the 15D instrument. A total of 453 PLWHIV from Finland were included in the thesis study. The most common modes of transmission were sexual contact among men having sex with men (55%) and among heterosexuals (33%). Of all the participants, 95% were receiving combination antiretroviral therapy (cART). The Finnish version of the WHOQOL-HIV-BREF showed satisfactory psychometric properties. However, the ability of the WHOQOL-HIV-BREF to assess physical and physiological dimensions of QoL was poor when compared to that of the 15D. PLWHIV in Finland reported better QoL than did those living in Portugal after controlling for sociodemographic and HIV-related variables. The QoL of PLWHIV in Finland is strongly influenced by psychological and socio-demographic variables and HIV-related stigma. HIV-related variables were not associated with the QoL in this population with well-controlled HIV infection. High levels of self-stigma were negatively associated with HRQoL and QoL and strongly associated with socio-demographic variables. When compared with the HRQoL of the general population, PLWHIV’s HRQoL was statistically significantly and clinically importantly lower, but did not differ from that of patients with the other chronic diseases (asthma, diabetes, and arthritis). PLWHIV were worst off in the psychological and sexual activity dimensions in both comparisons. Psychosocial factors are the core of the QoL of PLWHIV. In the era of modern cART, HIV-related factors do not seem to be associated with the QoL of PLWHIV. Further efforts must be devoted to identifying and developing adequate interventions to improve PLWHIV’s QoL.
Originalspråkengelska
Handledare
  • Roine, Risto Paavo Antero, Handledare
  • Sintonen, Harri, Handledare
  • Sutinen, Jussi Petteri, Handledare
UtgivningsortHelsinki
Förlag
Tryckta ISBN978-951-51-4487-4
Elektroniska ISBN978-951-51-4488-1
StatusPublicerad - 2018
MoE-publikationstypG5 Doktorsavhandling (artikel)

Vetenskapsgrenar

  • 3142 Folkhälsovetenskap, miljö och arbetshälsa
  • 3121 Inre medicin
  • 515 Psykologi

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