HIV IN THE WORLD

People's Psychosocial Strategies for Living With HIV

ABSTRACT

During the past decade? many investigations have examined the life circumstances of people living with HIV disease. Most of these studies? however? have focused on HIV-infected people in large metropolitan areas. This study compares the psychosocial profiles of rural and urban people living with HIV disease. This paper describes the relationship between psychosocial factors and health related quality of life among 287 HIV -positive people using items from the Medical Outcomes Study HIV Health Survey to measure physical functioning? mental health and overall quality of life. Multivariate models tested the relative importance of sociodemographic characteristics? HIV -related factors and psychosocial variables in explaining these quality of life outcomes. A history of child sexual abuse and adult abuse? social support and health promoting self-care behaviors were the psychosocial factors studied. People in the sample were on average 33 years old and had known they were HIV -positive for 41 months; 39% had been hospitalized at least once due to their HIV; 83% had children; 19% had a main sex partner who was also HIV -positive. More than one-half of the people (55%) had a history of injection drug use and 63% reported having been physically or sexually assaulted at least once as an adult. A history of childhood sexual abuse? reported by 41% of the sample? was significantly related to mental health after controlling for sociodemographic and HIV -related characteristics. People with larger social support networks reported better mental health and overall quality of life. People who practiced more self-care behaviors (healthy diet and vitamins? adequate sleep and exercise? and stress management) reported better physical and mental health and overall quality of life. The high prevalence of physical abuse and child sexual abuse reported by this sample underscores the importance of screening for domestic violence when providing services to HIV -positive people. That such potentially modifiable factor as social support and self care behaviors are strongly associated with health-related quality of life suggests a new opportunity to improve the lives of people living with HIV.

Table of Content

Introduction5

Methods7

Subjects and procedures7

Measures9

Health-related quality of life9

Sociodemographic characteristics11

HIV-related characteristics11

Psychosocial characteristics12

Social support12

Health promoting behaviors12

Adult violence history13

Child sexual abuse13

Analysis13

Results14

Sociodemographic characteristics14

HIV-related characteristics15

Psychosocial characteristics16

Correlates of health-related quality of life16

Multivariate analysis18

Discussion20

References30

People's Psychosocial Strategies for Living With HIV

Introduction

People represent an increasing proportion of those infected with HIV/AIDS; in the US an estimated 51?953 people are currently living with the disease (Centers for Disease Control? 1998). With improvements in treatment options? quality of life has become a central issue in the medical management of HIV-infected individuals who now can expect to live with their disease for many years. Quality of life encompasses multiple aspects of life satisfaction? such as: role functioning; self esteem; spiritual fulfillment; a sense of control over one's environment; a sense of security in the present and future; a sense of social integration? enjoyment? appreciation and pleasure (Andrews & Withey? 1976). Physical functioning? mental health status and social role functioning are also important dimensions of health-related quality of life (Wu ...