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Quality of Life Research

, Volume 22, Issue 8, pp 2073–2084 | Cite as

The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors

  • Tracy L. GardEmail author
  • Donald R. Hoover
  • Qiuhu Shi
  • Mardge H. Cohen
  • Eugene Mutimura
  • Adebola A. Adedimeji
  • Kathryn Anastos
Article

Abstract

Purpose

We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression.

Methods

The Rwandan Women’s Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV−) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics.

Results

Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV− women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms.

Conclusions

This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.

Keywords

Quality of life Post-traumatic stress disorder HIV Women Rwanda 

Abbreviations

CES-D

Center for Epidemiological Studies-Depression Scale

HAART

Highly active antiretroviral therapy

HIV

Human immunodeficiency virus

HQOL

Health-related quality of life

HTQ

Harvard Trauma Questionnaire

PLWH

Persons living with HIV

PTSD

Post-traumatic stress disorder

QOL

Quality of life

RWISA

Rwandan Women’s Interassociation Study and Assessment

SF-21

Short form-21

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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Tracy L. Gard
    • 1
    • 2
    Email author
  • Donald R. Hoover
    • 3
  • Qiuhu Shi
    • 4
  • Mardge H. Cohen
    • 5
  • Eugene Mutimura
    • 6
  • Adebola A. Adedimeji
    • 7
    • 8
  • Kathryn Anastos
    • 8
    • 9
  1. 1.Department of Psychiatry and Behavioral SciencesAlbert Einstein College of MedicineBronxUSA
  2. 2.Department of Psychiatry and Behavioral SciencesMontefiore Medical CenterBronxUSA
  3. 3.Statistics and Institute for Health, Health Care Policy and Aging ResearchRutgers UniversityNew BrunswickUSA
  4. 4.New York Medical CollegeValhallaUSA
  5. 5.Department of Medicine, Stroger (Cook County) HospitalRush UniversityChicagoUSA
  6. 6.Women’s Equity in Access to Care and Treatment (WE-ACTx)Kigali Health InstituteKigaliRwanda
  7. 7.Centre for Public Health SciencesAlbert Einstein College of MedicineBronxUSA
  8. 8.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  9. 9.Department of MedicineMontefiore Medical CenterBronxUSA

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