Abstract
Background
Prior research has widely recognized that the most essential negative predictors in people with chronic diseases’ quality of life are insomnia, fatigue, and pain. To date, there are little to no studies that have identified how these physical symptoms perform together and influence the quality of life, especially among people living with Human Immunodeficiency Virus (HIV). This study aimed to examine the relationships between insomnia, fatigue, pain, and quality of life in people with HIV.
Methods
People living with HIV (N = 200) who met the antiretroviral therapy criteria were recruited. Standardized scales for fatigue, pain, insomnia, antiretroviral therapy adherence, substance use, and quality of life were used to measure key study variables.
Results
Results showed with 95% confidence intervals that the increasing levels of fatigue (B = 1.026, p < 0.001) and insomnia (B = –0.589, p = 0.003) were negatively associated with quality of life in people living with HIV. The effect of fatigue on quality of life was significantly mediated via insomnia (Sobel test of mediation effect = 0.225, z = 2.883, p = 0.004). The increasing levels of pain (B = –1.682, p < 0.001) and insomnia (B = –1.171, p < 0.001) were negatively associated with quality of life.
Conclusions
The findings of moderated mediation analysis clarified the complex mechanism of how fatigue, insomnia, and opioid use influenced the quality of life and how pain, insomnia, and antiretroviral therapy adherence influence quality of life. It emphasizes the need for further interventions to target this complex interplay among physical symptoms and substance use to enhance the quality of life with antiretroviral therapy in people living with HIV.
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Data Availability
Data are available from the authors with the permission. The data supporting this study's findings are available from the corresponding author, HP, upon reasonable request.
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Funding
Directorate of Research and Development, Universitas Indonesia under Hibah Q3 2020 Grant Number NKB-1816/UN2.RST/HKP.05.00/2020. This work is supported by Universitas Indonesia PUTI Proceeding 2020, Grant number NKB-827/UN2.RST/HKP.05.00/2020.
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All authors made substantial contributions to the conception and design of the work and during the acquisition, analysis, and interpretation of data. All authors drafted the work and revised it critically for important intellectual content. All authors approved the final manuscript to be published. All authors area accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Pujasari, H., Umar, E. Insomnia and quality of life of adults living with HIV: a moderated mediation analysis. J Public Health (Berl.) 32, 749–757 (2024). https://doi.org/10.1007/s10389-023-01853-0
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DOI: https://doi.org/10.1007/s10389-023-01853-0