Quality of Life Research

, Volume 9, Issue 1, pp 55–63 | Cite as

Health-related quality of life among people with HIV disease: Results from the Multicenter AIDS Cohort Study

  • E.G. Bing
  • R.D. Hays
  • L.P. Jacobson
  • B. Chen
  • S.J. Gange
  • N.E. Kass
  • J.S. Chmiel
  • S.L. Zucconi
Article

Abstract

To examine the effect of HIV status, symptomatology and CD4+ lymphocyte level on health-related quality of life, the Medical Outcomes Study Short-Form Health Survey (SF-36) was administered to 2,295 gay men enrolled in the Multicenter AIDS Cohort Study (MACS) in 1994. Distinct physical and mental health factors of the SF-36 were found. Seropositive asymptomatic individuals and seropositive individuals with CD4+ lymphocytes ≥ 500/mm3 scored as well as seronegative participants on all of the mental health domain scales, but lower on the general health perceptions and physical health composite score. Seropositive individuals with at least one symptom or with CD4+ lymphocytes below 200/mm3 scored significantly lower on all of the SF-36 scales and summary scores than seronegative controls. The SF-36 was found to exhibit similar mental and physical health factors for an adult gay male population to that previously seen in general population samples and in patient groups with other diseases. In conclusion, HIV-positive men who are asymptomatic or have CD4+ lymphocytes above 500/mm3 have similar perceived mental health but worse perceived physical health than seronegative men. HIV-positive men who are symptomatic or have CD4+ lymphocytes below 200/mm3 have worse perceived mental and physical health than seronegative men.

Acquired immune deficiency syndrome (AIDS) factor analysis Functional status Health status Health status indicators Human immunodeficiency virus (HIV) Mental health Quality of life 

References

  1. 1.
    O'Keefe EA, Wood R. The impact of human immunodeficiency virus (HIV) infection on quality of life in a multicultural South African population. Qual Life Res 1996; 5: 275–280.Google Scholar
  2. 2.
    Hays RD, Shapiro MF. An overview of generic health-related quality of life measures for HIV research. Qual Life Res 1992; 1: 91–97.Google Scholar
  3. 3.
    Wu AW, Hays RD, Kelly S, Malitz F, Bozzette SA. Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS. Qual Life Res 1997; 6: 531–554.Google Scholar
  4. 4.
    Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Med Care 1992; 30: 473–483.Google Scholar
  5. 5.
    McHorney CA, Kosinski M, Ware JE. Comparisons of the costs and quality of norms for the SF-36 Health Survey collected by mail versus telephone interview: Results from a national survey. Med Care 1994; 32: 551–567.Google Scholar
  6. 6.
    Johnson PA, Goldman L, Orav EJ, Garcia T, Pearson SD, Lee TH. Comparison of the Medical Outcomes Study Short-Form 36-item health survey in black patients and white patients with acute chest pain. Med Care 1995; 33: 145–160.Google Scholar
  7. 7.
    Wells KB, Burnam MA, Rogers W, Hays RD, Camp P. The course of depression in adult outpatients: Results from the Medical Outcomes Study. Arch Gen Psychiatry 1992; 49: 788–794.Google Scholar
  8. 8.
    Nernez DR, Repasky DP, Whitehouse FW, Kahkonen DM. Ongoing assessment of health status in patients with diabetes mellitus. Med Care 1992; 30: MS112–MS124.Google Scholar
  9. 9.
    Hays RD, Kallick JD, Mapes DL, Coons SJ, Carter WB. Development of the Kidney Disease Quality of Life (KDQOL) instrument. Qual Life Res 1994; 3: 329–338.Google Scholar
  10. 10.
    Hays RD, Sherbourne CD, Mazel RM. The RAND 36-item health survey 1.0. Health Econ 1993; 2: 217–227.Google Scholar
  11. 11.
    Kantz ME, Harris WJ, Levitsky K, Ware JEJ, Davies JR. Methods for assessing condition-specific and generic function status outcomes after total knee replacement. Med Care 1992; 30: MS240–MS252.Google Scholar
  12. 12.
    McHorney CA, Ware JE, Lu JF, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across patient groups. Med Care 1994; 32: 40–66.Google Scholar
  13. 13.
    Wagner AK, Keller SD, Kosinski M, Baker GA, Jacoby A, Hsu MA, et al. Advances in methods for assessing the im-pact of epilepsy and antiepileptic drug therapy on patients' health-related quality of life. Qual Life Res 1995; 4: 115–134.Google Scholar
  14. 14.
    Hays RD, Marshall GN, Wang EYI, Sherbourne CD. Four-year cross-lagged associations between physical and mental health in the Medical Outcomes Study. J Counseling Clin Psychol 1994; 62: 441–449.Google Scholar
  15. 15.
    Ware JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: Summary of results from the Medical Outcomes Study. Med Care 1995; 33: AS264–AS279.Google Scholar
  16. 16.
    Radloff LS, Locke BZ. The Community Mental Health Assessment Survey and the CES-D scale. In: Weissman MM, Myers JK, Ross CG, eds, Community surveys of psychiatric disorders. New Brunswick: Rutgers University Press, 1985.Google Scholar
  17. 17.
    Lamping DL. Methods for measuring outcomes to evaluate interventions to improve health-related quality of life in HIV infection. Psychol Health 1994; 9: 31–49.Google Scholar
  18. 18.
    Tsevt J, Solzan J, Kuntz KM, Ragland J, Currier J, Sell RL, et al. Health values of patients infected with human immunodeficiency virus, relationship to mental health and physical functioning. Med Care 1996; 34: 44–57.Google Scholar
  19. 19.
    Kaslow RA, Ostrow DG, Detels R, Phair JP, Polk BF, Rinaldo CR, et al. The Multicenter AIDS Cohort Study: Rationale, organization, and selected characteristics of the participants. Am J Epidemiol 1987; 126: 310–318.Google Scholar
  20. 20.
    Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and interpretation guide. Boston: The Health Institute, 1993.Google Scholar
  21. 21.
    Centers for Disease Control. Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992; 41.Google Scholar
  22. 22.
    Giorgi JV, Cheng HL, Margolick JB, Bauer KD, Ferbas J, Waxdal M, et al. Quality control in the flow cytometric measurement of T-lymphocyte subsets: The Multicenter AIDS Cohort Study experience. Clin Immunol Immunopathol 1990; 55: 173–186.Google Scholar
  23. 23.
    Schenker EL, Hultin LE, Bauer KD, Ferbas J, Margolick JB, Giorgi JV. Evaluation of a dual-color flow cytometry immunophenotyping panel in a multicenter quality assurance program. Cytometry 1993; 14: 307–317.Google Scholar
  24. 24.
    Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychological Measurement 1977; 1: 385–401.Google Scholar
  25. 25.
    Breslan N. Depressive symptoms, major depression, and generalized anxiety: A comparison of self-reports on CES-D and results from diagnostic interviews. Psychiatry Res 1984; 15: 219–229.Google Scholar
  26. 26.
    Hendrickson AE, White PO. Promax: A quick method for rotation to oblique simple structure. B J Statistical Psychol 1964; 17: 65–70.Google Scholar
  27. 27.
    Nunnally J. Psychometric theory. 2nd ed. New York: Mc-Graw-Hill, 1978.Google Scholar
  28. 28.
    Cunningham WE, Shapiro MF, Hays RD, Dixon WJ, Visscher BR, George L, et al. Constitutional symptoms and health-related quality of life in persons with symptomatic human immunodeficiency virus disease. Am J Med 1998; In press.Google Scholar
  29. 29.
    Winiarski MG. AIDS-related psychotherapy. New York: Pergamon Press, 1991.Google Scholar
  30. 30.
    Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, et al. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA 1989; 262: 914–919.Google Scholar
  31. 31.
    Sherbourne CD, Wells KB, Judd LL. Functioning and well-being of patients with panic disorder. Am J Psychiatry 1996; 153: 213–218.Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • E.G. Bing
    • 1
  • R.D. Hays
    • 2
  • L.P. Jacobson
    • 3
  • B. Chen
    • 3
  • S.J. Gange
    • 3
  • N.E. Kass
    • 4
  • J.S. Chmiel
    • 5
  • S.L. Zucconi
    • 6
  1. 1.Department of PsychiatryCharles R. Drew University of Medicine & ScienceLos AngelesUSA
  2. 2.RANDUCLA School of MedicineUSA
  3. 3.Department of EpidemiologyJohns Hopkins School of Hygiene and Public HealthUSA
  4. 4.Program in Law, Ethics, and HealthJohns Hopkins School of Hygiene and Public Health and Bioethics InstituteUSA
  5. 5.Department of Preventive MedicineNorthwestern Univerisity Medical SchoolUSA
  6. 6.The Nemours FoundationUSA

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