Ghanaians living with Human Immunodeficiency Virus: social determinants of quality of life
摘要
Social variables have a significant impact on the quality of life (QoL) of people living with Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (PLWHA). Understanding how marital status, employment, and current illness influence QoL is critical for establishing holistic care strategies. Using the World Health Organization Quality of Life for HIV – Brief version (WHOQOL-HIV BREF) instrument, this study investigates the association between these socioeconomic variables and quality of life across various domains.
MethodsOne hundred and fifty-seven participants living with HIV/AIDS were included in this cross-sectional study. Data were collected using the WHOQOL-HIV BREF questionnaire, which assessed six domains of QoL: Physical Health, Psychological Well-being, Level of Independence, Social Relationships, Environment, and Spirituality/Religion/Personal Beliefs. Data were organized using Microsoft Excel 2019 and analyzed with SPSS Version 26 and R software. Descriptive statistics summarized participant characteristics. Using the Kruskal-Wallis and Wilcoxon rank-sum tests, bivariate analyses identified associations between sociodemographic factors and QoL domains. Variables with p-values less than 0.25 were included in multivariate logistic regression models to identify significant determinants of QoL.
ResultsIn 157 participants, 70.7% were females, and 69.9% were between the ages of 18 and 39. Participants who were currently married reported higher QoL scores in the physical health domain compared to those not married (median = 18.0 vs. 17.0; p = 0.035). Employed individuals had higher scores in level of independence (median = 18.0 vs. 15.0; p < 0.001) and social relationships (median = 15.0 vs. 13.5; p = 0.031) compared to the unemployed. Participants without a current illness had significantly higher QoL scores across all domains, including physical health (median = 19.0 vs. 14.5; p < 0.001) and psychological well-being (median = 16.0 vs. 14.4; p < 0.001). Multivariate analysis showed that being unmarried (β = −4.7; p = 0.044), unemployed (β = −8.0; p = 0.015), and having a current illness (β = −11.0; p < 0.001) were significant predictors of lower QoL.
ConclusionsSocial determinants of health significantly impact the QoL of PLWHA. Specifically, being unmarried, unemployed, or currently ill was associated with lower QoL across multiple domains. These findings highlight the need for holistic interventions that address social and economic factors in addition to medical care. Enhancing social support, providing employment opportunities, and effectively managing health conditions may improve the overall well-being of PLWHA.