Quality of Life Research

, Volume 15, Issue 1, pp 69–82 | Cite as

The Effect of Diagnosis with HIV Infection on Health-Related Quality of Life

  • Shyoko Honiden
  • Vandana Sundaram
  • Robert F. Nease
  • Mark Holodniy
  • Laura C. Lazzeroni
  • Andrew Zolopa
  • Douglas K. Owens
Article

Abstract

We sought to understand how diagnosis with HIV affects health-related quality of life. We assessed health-related quality of life using utility-based measures in a Department of Veterans Affairs (VA) clinic and a University-based clinic. Respondents assessed health-related quality of life regarding their current health, and retrospectively assessed their health 1 month prior to and 2 months after diagnosis with HIV infection. Sixty-six patients completed the study. The overall mean utilities for health 1 month before and 2 months after diagnosis were 0.87 (standard error 0.037), and 0.80 (0.043) (p<0.005 by rank sign test), but the effect of diagnosis differed between the two clinics, with a substantial decrease in the university clinic and a small non-significant decrease in the VA clinic. The overall mean utility for current health was 0.85 (0.034), assessed on average 7.5 years after diagnosis. When asked directly whether diagnosis of HIV decreased health-related quality of life, 47% agreed, but 35% stated that HIV diagnosis positively affected health-related quality of life. Diagnosis with HIV decreased health-related quality of life at 2 months on average, but this effect diminished over time, and differed among patient populations. Years after diagnosis, although half of the patients believed that diagnosis reduced health-related quality of life, one-third reported improved health-related quality of life.

Keywords

HIV Diagnosis Quality of life Retrospective study Utility assessment 

Abbreviations

AIDS

acquired immune deficiency syndrome

CDC

Centers for Disease Control and Prevention

HAART

highly active antiretroviral therapy

HIV

human immunodeficiency virus

MOS-HIV

Medical Outcomes Study-HIV Health Survey

QOL

quality of life

TTO

time trade-off

VA

Department of Veterans Affairs

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Centers for Disease Control and Prevention. Advancing HIV prevention: New strategies for a changing epidemic – United States, 2003. MMWR Morb Mortal Wkly Rep 2003; 52(15): 329–332Google Scholar
  2. 2.
    Centers for Disease Control and Prevention. Revised Guidelines for HIV Counseling, Testing, and Referral and Revised Recommendations for HIV Screening of Pregnant Women. MMWR 2001; 50(No. RR-19): 16–19Google Scholar
  3. 3.
    Gage, BF, Cardinalli, AB, Owens, DK 1996The effect of stroke and stroke prophylaxis with aspirin or warfarin therapy on quality of lifeArch Intern Med15618291836CrossRefPubMedGoogle Scholar
  4. 4.
    McNeil, BJ, Weichselbaum, R, Pauker, SG 1981Speech and survival. Tradeoffs between quality and quantity of life in laryngeal cancerN Engl J Med305982987PubMedCrossRefGoogle Scholar
  5. 5.
    Tsevat, J, Sherman, SN, McElwee, JA,  et al. 1999The will to live among HIV-infected patientsAnn Intern Med131194198PubMedGoogle Scholar
  6. 6.
    Gold, MRSiegel, JERussell, LBWeinstein, MC eds. 1996Cost Effectiveness in Health and MedicineOxford University PressNew York, NYGoogle Scholar
  7. 7.
    Sanders, GD, Bayoumi, AM, Sundaram, V,  et al. 2005Cost-effectiveness of screening for HIV in the era of highly active␣antiretroviral therapyN Engl J Med352570585CrossRefPubMedGoogle Scholar
  8. 8.
    Paltiel, AD, Weinstein, MC, Kimmel, AD,  et al. 2005Expanded screening for HIV in the United States – an analysis of cost-effectivenessN Engl J Med352586595CrossRefPubMedGoogle Scholar
  9. 9.
    Owens, DK, Nease, RF,Jr., Harris, RA 1996Cost-effectiveness of HIV screening in acute care settingsArch Intern Med156394404CrossRefPubMedGoogle Scholar
  10. 10.
    Torrance, GW 1987Utility approach to measuring health-related quality of lifeJ Chronic Dis40593603CrossRefPubMedGoogle Scholar
  11. 11.
    Sox, H, Blatt, M, Higgins, M, Marton, K 1988Medical Decision Making BostonButterworthsMassachusettsGoogle Scholar
  12. 12.
    Weinstein, M, Fineberg, H 1980Clinical Decision AnalysisWB Saunders Co.Philadelphia, PAGoogle Scholar
  13. 13.
    Sumner W, Nease R, Littenberg B. U-titer: A utility assessment tool. Proc Annu Symp Comput Appl Med Care 1991: 701–705Google Scholar
  14. 14.
    Sanders GD, Owens DK, Padian N, Cardinalli AB, Sullivan AN, Nease RF. A computer-based interview to identify HIV risk behaviors and to assess patient preferences for HIV-related health states. Proc Annu Symp Comput Appl Med Care 1994: 20–24Google Scholar
  15. 15.
    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
  16. 16.
    Stewart, AL, Hays, RD, Ware, JE,Jr 1988The MOS short-form general health survey. Reliability and validity in a patient populationMed Care26724735PubMedGoogle Scholar
  17. 17.
    Revicki, DA, Wu, AW, Murray, MI 1995Change in clinical status, health status, and health utility outcomes in HIV-infected patientsMed Care33AS173AS182PubMedGoogle Scholar
  18. 18.
    Copfer, AE, Ampel, NM, Hughes, TE,  et al. 1996The use of two measures of health-related quality of life in HIV-infected individuals: A cross-sectional comparisonQual Life Res5281286CrossRefPubMedGoogle Scholar
  19. 19.
    Wu, AW, Mathews, WC, Brysk, LT,  et al. 1990Quality of life in a placebo-controlled trial of zidovudine in patients with AIDS and AIDS-related complexJ Acquir Immune Defic Syndr3683690PubMedGoogle Scholar
  20. 20.
    Lenert, LA, Sturley, A, Rupnow, M 2003Toward improved methods for measurement of utility: Automated repair of errors in elicitationsMed Decis Making236775CrossRefPubMedGoogle Scholar
  21. 21.
    Mrus, JM, Williams, PL, Tsevat, J, Cohn, SE, Wu, AW 2005Gender differences in health-related quality of life in patients with HIV/AIDSQual Life Res14479491CrossRefPubMedGoogle Scholar
  22. 22.
    Jansen, SJ, Kievit, J, Nooij, MA, Stiggelbout, AM 2001Stability of patients’ preferences for chemotherapy: The impact of experienceMed Decis Making21295306CrossRefPubMedGoogle Scholar
  23. 23.
    Mrus JM, Leonard AC, Yi MS, et al. Health-related quality of life in veterans and non-veterans with HIV/AIDS. HSRD 2004 National Meeting. Washington, D.C.; 2004Google Scholar
  24. 24.
    Anderson, JP, Kaplan, RM, Coons, SJ, Schneiderman, LJ 1988Comparison of the Quality of Well-being Scale and the SF-36 results among two samples of ill adults: AIDS and other illnessesJ Clin Epidemiol51755762Google Scholar
  25. 25.
    Bayoumi, AM, Redelmeier, DA 1998Preventing Mycobacterium avium complex in patients who are using protease inhibitors: A cost-effectiveness analysisAids1215031512CrossRefPubMedGoogle Scholar
  26. 26.
    Bayoumi, AM, Redelmeier, DA 1999Economic methods for measuring the quality of life associated with HIV infectionQual Life Res8471480CrossRefPubMedGoogle Scholar
  27. 27.
    Birkmeyer, JD, AuBuchon, JP, Littenberg, B,  et al. 1994Cost-effectiveness of preoperative autologous donation in coronary artery bypass graftingAnn Thorac Surg57161168discussion 168–169PubMedCrossRefGoogle Scholar
  28. 28.
    Birkmeyer, JD, Goodnough, LT, AuBuchon, JP, Noordsij, PG, Littenberg, B 1993The cost-effectiveness of preoperative autologous blood donation for total hip and knee replacementTransfusion33544551CrossRefPubMedGoogle Scholar
  29. 29.
    Busch, MP, Dodd, RY, Lackritz, EM, AuBuchon, JP, Birkmeyer, JD, Petersen, LR 1997Value and cost-effectiveness of screening blood donors for antibody to hepatitis B core antigen as a way of detecting window-phase human immunodeficiency virus type 1 infections. The HIV Blood Donor Study GroupTransfusion3710031011PubMedGoogle Scholar
  30. 30.
    Cleary, PD, Fowler, FJ,Jr, Weissman, J,  et al. 1993Health-related quality of life in persons with acquired immune deficiency syndromeMed Care31569580PubMedGoogle Scholar
  31. 31.
    Etchason, J, Petz, L, Keeler, E,  et al. 1995The cost effectiveness of preoperative autologous blood donationsN Engl J Med332719724CrossRefPubMedGoogle Scholar
  32. 32.
    Fawzy, FI, Namir, S, Wolcott, DL, Mitsuyasu, RT, Gottlieb, MS 1989The relationship between medical and psychological status in newly diagnosed gay men with AIDSPsychiatr Med72333PubMedGoogle Scholar
  33. 33.
    Gelber, RD, Lenderking, WR, Cotton, DJ,  et al. 1992Quality-of-life evaluation in a clinical trial of zidovudine therapy in patients with mildly symptomatic HIV infection.The AIDS Clinical Trials GroupAnn Intern Med116961966PubMedGoogle Scholar
  34. 34.
    Holtgrave, DR, Qualls, NL 1995Threshold analysis and programs for prevention of HIV infectionMed Decis Making15311317PubMedGoogle Scholar
  35. 35.
    Kaplan, RM, Anderson, JP, Patterson, TL,  et al. 1995Validity of the Quality of Well-Being Scale for persons with human immunodeficiency virus infection. HNRC Group. HIV Neurobehavioral Research CenterPsychosom Med57138147PubMedGoogle Scholar
  36. 36.
    Owens, DK, Nease, RF 1994

    Transmission of HIV infection between provider and patient: A quantitative analysis of risk

    Kaplan, EHBrandeau, ML eds. Modeling the AIDS Epidemic: Planning, Policy and PredictionRaven PressNew York153157
    Google Scholar
  37. 37.
    Owens, DK, Cardinalli, AB, Nease, RF,Jr 1997Physicians’ assessments of the utility of health states associated with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infectionQual Life Res67786CrossRefPubMedGoogle Scholar
  38. 38.
    Paltiel, AD, Scharfstein, JA, Seage, GR,3rd,  et al. 1998A Monte Carlo simulation of advanced HIV disease: application to prevention of CMV infectionMed Decis Making18S93S105PubMedGoogle Scholar
  39. 39.
    Roach, PJ, Fleming, C, Hagen, MD, Pauker, SG 1988Prostatic cancer in a patient with asymptomatic HIV infection: Are some lives more equal than others?Med Decis Making8132144PubMedGoogle Scholar
  40. 40.
    Schag, CA, Ganz, PA, Kahn, B, Petersen, L 1992Assessing the needs and quality of life of patients with HIV infection: Development of the HIV Overview of Problems-Evaluation System (HOPES)Qual Life Res1397413CrossRefPubMedGoogle Scholar
  41. 41.
    Scharfstein, JA, Paltiel, AD, Freedberg, KA 1997The cost-effectiveness of fluconazole prophylaxis against primary systemic fungal infections in AIDS patientsMed Decis Making17373381PubMedGoogle Scholar
  42. 42.
    Tsevat, J, Solzan, JG, Kuntz, KM,  et al. 1996Health values of patients infected with human immunodeficiency virus. Relationship to mental health and physical functioningMed Care344457CrossRefPubMedGoogle Scholar
  43. 43.
    Tramarin, A, Milocchi, F, Tolley, K,  et al. 1992An economic evaluation of home-care assistance for AIDS patients: A pilot study in a town in northern ItalyAids613771383PubMedGoogle Scholar
  44. 44.
    Tengs, TO, Lin, TH 2002A meta-analysis of utility estimates for HIV/AIDSMed Decis Making22475481CrossRefPubMedGoogle Scholar
  45. 45.
    Levine, M, Haslam, D, Walter, S,  et al. 2002

    Harm

    Guyatt, GRennie, D eds. Users’ Guides to the Medical Literature4American Medical Association PressChicago, IL90
    Google Scholar
  46. 46.
    Blaxter, M 1982E. P. Mothers and Daughters: A Three Generational Study of Health Attitudes and BehaviorHeinemannLondonGoogle Scholar
  47. 47.
    Law, MG, Hurley, SF, Carlin, JB, Chondros, P, Gardiner, S, Kaldor, JM 1996A comparison of patient interview data with pharmacy and medical records for patients with acquired immunodeficiency syndrome or human immunodeficiency virus infectionJ Clin Epidemiol499971002CrossRefPubMedGoogle Scholar
  48. 48.
    Skeff, KM, Stratos, GA, R, BM 1992Evaluation of medical faculty development program: a comparison of traditional pre/post and retrospective pre/post self-assessment ratingsEval Health Prof15350366Google Scholar
  49. 49.
    Bray, J. 1984Methods of analysis with response-shift biasEduc psychol meas44781804Google Scholar
  50. 50.
    Tousignant, P, Cosio, MG, Levy, RD, Groome, PA 1994Quality adjusted life years added by treatment of obstructive sleep apneaSleep175260PubMedGoogle Scholar
  51. 51.
    Busschbach, JJ, Horikx, PE, Bosch, JM, Bruteldela Riviere, A, Charro, FT 1994Measuring the quality of life before and after bilateral lung transplantation in patients with cystic fibrosisChest105911917PubMedGoogle Scholar
  52. 52.
    Robb, B, Pritts, T, Gang, G,  et al. 2002Quality of life in patients undergoing ileal pouch-anal anastomosis at the University of CincinnatiAm J Surg183353360CrossRefPubMedGoogle Scholar
  53. 53.
    McLeod, RS, Churchill, DN, Lock, AM, Vanderburgh, S, Cohen, Z 1991Quality of life of patients with ulcerative colitis preoperatively and postoperativelyGastroenterology10113071313PubMedGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Shyoko Honiden
    • 1
    • 2
  • Vandana Sundaram
    • 1
    • 3
  • Robert F. Nease
    • 4
  • Mark Holodniy
    • 1
    • 2
  • Laura C. Lazzeroni
    • 5
  • Andrew Zolopa
    • 2
  • Douglas K. Owens
    • 1
    • 3
  1. 1.VA Palo Alto Health Care System (111A)Palo Alto
  2. 2.Stanford School of MedicineStanford UniversityStanford
  3. 3.Center for Primary Care and Outcomes Research, Department of MedicineStanford UniversityStanford
  4. 4.Express Scripts Inc.Maryland Heights
  5. 5.Department of Health Research and Policy, School of MedicineStanford UniversityStanford

Personalised recommendations