Quality of Life Research

, Volume 14, Issue 6, pp 1641–1647 | Cite as

Assessment of quality of life among HIV-infected persons in Pune, India

  • Rewa M. Kohli
  • Suvarna Sane
  • Kishore Kumar
  • Ramesh S. Paranjape
  • Sanjay M. Mehendale


Objective: To study dimensions of Quality of Life (QOL) amongst HIV infected persons, their relationship with socio-demographic characteristics and disease progression.

Design: Cross-sectional study with one time assessment of QOL.

Methods: Modified Medical Outcome Study (MOS) core instrument [The Medical Outcome Study 116 core set of Measures of functioning and well being, Appendix A, core survey instrument (internet)] was interview -administered to 100 HIV infected individuals.

Results: The instrument showed significant positive inter-domain correlations and desired linear association between QOL scores and the CD4 counts. The scale had a Cronbach α value of 0.75. QOL was markedly affected in the domains of physical health, work and earnings, routine activities and appetite and food intake. Women had significantly lower QOL scores than men despite having less advanced disease. The QOL scores were significantly lower among persons with lower CD4 counts mainly in different domains of physical health.

Conclusions: The modified MOS scale had the desired reliability and validity for evaluation of QOL in the HIV-infected persons in India. Low scores in the domains of physical health compared to other domains suggest a strategy to focus on medical intervention. A need for psychosocial intervention for women was perceived. Longitudinal studies must be done to assess the impact of anti-retroviral therapy being rolled out through the national programme on QOL.


AIDS HIV India Progression of HIV disease QOL 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    The Medical Outcome Study 116 core set of measures of functioning and well being, Appendix A, Core survey instrument (Internet).Google Scholar
  2. 2.
    Low-Beers, S, Chan, K, Wood, E,  et al. 2000Health related quality of life among persons with HIV after the use of protease inhibitorsQual Life Res8941949CrossRefGoogle Scholar
  3. 3.
    Wu, A. 2000Quality of life assessment comes of age in the era of highly active antiretroviral therapyAIDS1414491451PubMedGoogle Scholar
  4. 4.
    Scott-Lennox, JA, Mills, RJ, Burt, MS. 1998Impact of Zidovudin plus lamivudin or Zalcitabine on health related quality of lifeAnn Pharmacother32525530CrossRefPubMedGoogle Scholar
  5. 5.
    Revicki, DA, Moyle, G, Stellbrink, H,  et al. 1999Quality of life outcomes of combination Zalcitabine–Zidovudin, Sequinavir–Zidovudin, and Sequinavir–Zalcitabine–Zidovudin therapy for HIV-infected adults with CD4 cell counts between 50 and 350 per cubic millimetreAIDS13851858PubMedGoogle Scholar
  6. 6.
    Cohen, C, Revicki, DA, Nabulsi, A,  et al. 1998A randomised trial of the effect of ritonavir in maintaining quality of life in advanced HIV diseaseAIDS12495502CrossRefPubMedGoogle Scholar
  7. 7.
    Paton, NI, Chapman, CA, Chan, SP,  et al. 2002Validation of the medical outcome study HIV (1), health survey as a measure of quality of life in HIV infected patients in SingaporeInt J STD AIDS13456461CrossRefPubMedGoogle Scholar
  8. 8.
    Lubeck, DP, Fries, JF. 1997Assessment of quality of life in early stage HIV-infected persons: Data from the AIDS Time – Oriented Health Outcome Study (ATHOS)Qual Life Res6494506PubMedGoogle Scholar
  9. 9.
    Eriksson, LE, Nordstron, G, Berglund, T,  et al. 2000The health related quality of life in a Swedish sample of HIV infected personsJ Adv Nurs32213223CrossRefGoogle Scholar
  10. 10.
    Cowdery, JE, Pesa, JA. 2002Assessing quality of life in women living with HIV InfectionAIDS Care14235245PubMedGoogle Scholar
  11. 11.
    Hays, RD, Shapiro, MF. 1992An overview of generic health related quality of life measures for HIV researchQual Life Res19198CrossRefPubMedGoogle Scholar
  12. 12.
    The WHOQOL HIV Group. Initial steps to developing the World Health Organisation’s Quality of Life Instrument (WHOQOL) module for International assessment in HIV/AIDS, AIDS Care 2003; 15: 347–357.Google Scholar
  13. 13.
    Brown L, Ruth L. Review of instruments assessing health related quality of life, excerpts from “A review of approaches and instruments for assessing health – Related quality of life” Tulane University /Horizon (Internet).Google Scholar
  14. 14.
    Franchi, D, Wenel, RP. 1998Measuring health related quality of life among patients infected with human immunodeficiency virusClin Infect Dis262026PubMedGoogle Scholar
  15. 15.
    Douaihy, A, Singh, N. 2001Factors affecting quality of life in patients with HIV infectionAIDS Reader11444449PubMedGoogle Scholar
  16. 16.
    CDC. Revision of the case definition of acquired immuno-deficiency syndrome for national reporting. US MMWR 1985; 34: 373–375.Google Scholar
  17. 17.
    Miners, AH, Sabin, CA, Mocroft, A,  et al. 2001Health-related quality of life in individuals infected with HIV in the era of HAARTHIV Clin Trials2484492PubMedGoogle Scholar
  18. 18.
    Carrieri, P, Spire, B, Duran, S,  et al. 2003Health related quality of life after one year of highly active antiretroviral therapyJ AIDS323847Google Scholar
  19. 19.
    Wu, AW, Jacobson, DL, Frick, KD,  et al. 2002Validity and responsiveness of the EuroQol as a measure of health related Quality of life in people enrolled in an AIDS clinical trialQual Life Res11273282PubMedGoogle Scholar
  20. 20.
    Huba GJ, Melchior LA. A report: Executive summary on Self perceived quality of life among HIV/AIDS patients in treatment within the Fort Lauderdale/Broward County Ryan White Title 1 Eligible Metropolitan Area. 2002. The measurement Group LLc, 5811A Uplander Way, Culver City, California 90230,888.864.4636. www.Themeasurement Group.comGoogle Scholar
  21. 21.
    Gill, CJ, Grffith, JL, Jacobson, D,  et al. 2002Relationship of HIV viral loads, CD4 counts, and HAART use to health related quality of lifeJ AIDS30485492Google Scholar
  22. 22.
    Han, C, Pulling, CC, Telke, SE,  et al. 2002Assessing the utility of five domains in SF-12 health status questionnaire in an AIDS clinical trialAIDS16431439PubMedGoogle Scholar
  23. 23.
    Campsmith, MI, Nakashima, AK, Davidson, AJ. 2003Self reported health related quality of life in persons with HIV infection: Results from multi-sites interview projectHealth Qual Life Outcomes112PubMedGoogle Scholar
  24. 24.
    Cedrerfjall, C, Langius-Eklof, A, Lidman, K,  et al. 2001Gender differences in the perceived heath related quality of life among patients with HIV infectionAIDS Patient Care STD153139PubMedGoogle Scholar
  25. 25.
    McDonnell, KA, Gielen, AC, Wu, AW,  et al. 2000Measuring health related quality of life among women living with HIVQual Life Res9931940PubMedGoogle Scholar
  26. 26.
    Landerking, WR, Testa, MA, Katsenstein, D,  et al. 1997Measuring quality of life in HIV early disease: The modular approachQual Life Res6515530PubMedGoogle Scholar
  27. 27.
    Watchel, T, Piette, J, Mor, V,  et al. 1992Quality of life in persons with human immunodeficiency virus infection: Measurement by the medical outcome study instrumentAnn Intern Med116129137PubMedGoogle Scholar
  28. 28.
    Smith, MY, Feldmen, J, Kelly, P,  et al. 1996Health related quality of life of HIV infected women: Evidence for the reliability, validity and responsiveness of the medical outcomes study short form 20Qual Life Res54755CrossRefPubMedGoogle Scholar
  29. 29.
    Phillips KD, Sowell RL, Rush C et al. Psychosocial and physiologic correlates of perceived health among HIV infected women. Southern Online J Nurs Res 2001; 2.Google Scholar
  30. 30.
    Starace, F, Cafaro, L, Abrescia, N,  et al. 2002Quality of life assessment in HIV positive persons: application & validation of WHOQOL-HIV, Italian versionAIDS Care14405415PubMedGoogle Scholar
  31. 31.
    Borgo, CD, Izzi, I, Chiarotti, F,  et al. 2001Multidimensional aspects of pain in HIV-infected individualsAIDS Patient Care STD1595102Google Scholar
  32. 32.
    Badia, X, Podzamczer, D, Garcia, M,  et al. 1999the Spanish MOS-HIV and MQOL-HIV Validation Group. A randomised study comparing instruments for measuring health related quality of life in HIV-infected patientsAIDS1317271735PubMedGoogle Scholar
  33. 33.
    Murri, R, Ammassari, A, Fantoni, M,  et al. 1997Disease related factors associated with health related quality of life in people with non-advanced HIV disease assessed using an Italian version of the MOS-HIV health SurveyJ AIDS16350356Google Scholar
  34. 34.
    Wu, AW, Rubin, HR, Mathews, WC,  et al. 1991A health status questionnaire using 30 items from the medical outcomes study. Preliminary validation in persons with early HIV infectionMed Care29786798PubMedGoogle Scholar
  35. 35.
    Ware, JE, Kosinski, M, Gandek, B,  et al. 1998The factor structure of SF-36 health survey in 10 countries: Results from the IQOLA projectJ Clin Epidemiol5111591165PubMedGoogle Scholar
  36. 36.
    Wu, AW, Revicki, DA, Jacobson, D,  et al. 1997Evidence for reliability, validity and usefulness of the Medical Outcome Study HIV health survey (MOS-HIV)Qual Life Res6481493PubMedGoogle Scholar
  37. 37.
    Chesney, MA, Folkman, S. 1994Psychological impact of HIV disease and implications for interventionPsychiatr Clin North Am17163182PubMedGoogle Scholar
  38. 38.
    Nunes, JA, Raymond, SJ, Nicholas, PK,  et al. 1995Social support, quality of life, immune function and health in persons living with HIVJ Holist Nurs13174198PubMedGoogle Scholar
  39. 39.
    Cunningham, WE, Shapiro, MF, Hays, RD,  et al. 1998Constitutional symptoms and health related quality of life of patients with symptomatic HIV diseaseAm J Med104129136PubMedGoogle Scholar
  40. 40.
    Globe, DR, Hays, RD, Cunningham, WE. 1999Association of Clinical parameters with health related quality of life in hospitalised persons with HIV diseaseAIDS Care117186PubMedGoogle Scholar
  41. 41.
    Weinfurt, KP, Willke, RJ, Glick, HA,  et al. 2000Relationship between CD4 count, viral burden, and quality of life over time in HIV-1 infected patientsMed Care38404410PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Rewa M. Kohli
    • 1
  • Suvarna Sane
    • 1
  • Kishore Kumar
    • 1
  • Ramesh S. Paranjape
    • 1
  • Sanjay M. Mehendale
    • 1
  1. 1.National AIDS Research InstituteIndian Council of Medical ResearchPuneIndia

Personalised recommendations