Health-Related Quality of Life in HIV-Infected Men Who Have Sex with Men in China: A Cross-Sectional Study
Bo Song, Cunling Yan, Yuanlong Lin, Fuxiang Wang, Limei Wang
(Department of Infectious Diseases, Fourth Afﬁliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland))
Med Sci Monit 2016; 22:2859-2870
China is undergoing a rapid growth in the human immunodeficiency virus (HIV) epidemic involving men who have sex with men (MSM). Reports about their health-related quality of life (HRQOL) are scarce. This study aimed to assess the HRQOL and factors influencing HIV-positive MSM in a city in the northeast of China.
MATERIAL AND METHODS: A cross-sectional study was conducted in Harbin city (Heilongjiang, China). HIV-positive MSM (n=125) were interviewed using the WHOQOL-HIV-BRIEF scale, the Berger HIV Stigma Scale, and other HIV-related questionnaires from June to August 2013.
RESULTS: Among the 6 dimensions of the HRQOL, HIV-related stigma was negatively associated with psychological (r=–0.316, P=0.0003) and spirituality domains (r=–0.324, P=0.0002). Physician support was positively associated with independence domain (r=0.393, P<0.0001). Hostile mentality was associated with psychological (r=0.479, P<0.0001) and spirituality domains (r=0.431, P<0.0001). Adverse effects of HAART were significantly correlated with physical (r=–0.542, P<0.0001) and psychological (r=–0.554, P<0.0001) domains. Multiple logistic regression showed that stigma (odds ratio (OR)=1.251, 95% confidence interval (95%CI): 1.088–1.439, P=0.002) and adverse effects of HAART (OR=1.117, 95%CI: 1.069–1.167, P<0.0001) were independent risk factors for low HRQOL. Physician support (OR=0.961, 95%CI: 0.941–0.982, P=0.0002) and CD4+ counts >350 (OR=0.033, 95%CI: 0.005–0.208, P=0.001) were independent protective factors in MSM receiving HAART. Hostile mentality (OR=0.936, 95%CI: 0.906–0.967, P<0.0001) was an independent protective factor of HRQOL in MSM not receiving HAART.
CONCLUSIONS: Psychological factors such as HIV-related stigma, hostile mentality, and physician support have a significant effect on HRQOL in MSM. These findings suggest specific psychological interventions to improve HRQOL in HIV-positive MSM in China.
Keywords: Cross-Sectional Studies, China - epidemiology, Adult, HIV Infections - psychology, Homosexuality, Male - statistics & numerical data, Humans, Male, Middle Aged, Odds Ratio, Quality of Life, Risk Factors, Surveys and Questionnaires