Health Services Research & Development

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2006 HSR&D National Meeting Abstract


3042 — The Impact of Psychosocial Factors and CD4 Count on HRQoL Change among HIV-Infected Veterans

Author List:
Jia HC (Rehabilitation Outcomes Research Center)
Uphold CR (Rehabilitation Outcomes Research Center)
Zheng YE (Rehabilitation Outcomes Research Center)
Wu SS (Rehabilitation Outcomes Research Center)
Chen GJ (Medical University of South Carolina)
Duncan PW (Rehabilitation Outcomes Research Center)

Objectives:
The objective of this study was to examine the longitudinal relationship between active coping, social support, and CD4 count with HRQoL in male veterans with HIV infection.

Methods:
In a prospective cohort study on health outcomes in HIV-infected men, baseline and 12-month followup data were collected on 121 veterans with HIV infection. Data included in this study were patient sociodemographic, clinical, coping strategy (Coping Instrument), social support (SS-A), and HRQoL variables. Multivariable mixed random effect regression models with repeated measures were fit to assess the longitudinal effects of the independent variables on each HRQoL dimension used, controlling for patient age, ethnicity, family income, comorbidity, HIV duration, and study time.

Results:
Of this sample, 42% were non-white, 55% had annual family income of greater than $20,000, with a mean age of 47 years. The mean scores at baseline were 1 for Charlson’s comorbidity after excluding AIDS diagnosis, 9 years for HIV infection duration, and 474 for CD4 count. All HRQoL dimensions had changed over the 12-month study period with mean change scores ranging between –2 for role function and 4 for social function. Our regression analyses showed that active coping was significantly associated with improved energy and overall QoL; social support with improved social function, role function, emotional well being, mental health, and overall QoL; and CD4 count with improved physical and social function. No significant interaction with time was found for active coping and social support on HRQoL except CD4 count.

Implications:
Our study suggested that active coping and social support were consistently significant predictors of improved HRQoL dimensions both at baseline and followup. CD4 count at baseline was significantly predictive of physical and social function, but patients with higher baseline CD4 count had smaller HRQoL change over the 12-months.

Impacts:
Our findings on the significant, longitudinal impact of active coping, social support, and CD4 on HRQoL may assist program planners in developing social and medical service delivery for HIV-infected male veterans, and facilitate the development of treatment and intervention programs aimed at increasing the QoL for the population.