Journal of General Internal Medicine

, Volume 21, Supplement 5, pp S39–S47

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

  • Joseph M. Mrus
  • Anthony C. Leonard
  • Michael S. Yi
  • Susan N. Sherman
  • Shawn L. Fultz
  • Amy C. Justice
  • Joel Tsevat
Original Articles

DOI: 10.1111/j.1525-1497.2006.00644.x

Cite this article as:
Mrus, J.M., Leonard, A.C., Yi, M.S. et al. J GEN INTERN MED (2006) 21(Suppl 5): S39. doi:10.1111/j.1525-1497.2006.00644.x

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.

Key words

HIV AIDS quality of life veterans 

Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Joseph M. Mrus
    • 1
    • 2
  • Anthony C. Leonard
    • 2
  • Michael S. Yi
    • 2
  • Susan N. Sherman
    • 2
  • Shawn L. Fultz
    • 3
    • 4
  • Amy C. Justice
    • 3
    • 4
  • Joel Tsevat
    • 1
    • 2
  1. 1.Cincinnati VA Medical CenterCincinnatlUSA
  2. 2.University of CinoinnatiCincinnatiUSA
  3. 3.VA Connecticut Healthcare SystemWest HavenUSA
  4. 4.Yale University School of MedicineNew HavenUSA
  5. 5.Tibotec TherapeuticsBridgewater