Health-related quality of life among antiretroviral therapy (ART) experienced and ART naїve adults attending an urban HIV clinic in Kampala, Uganda

Abstract

Introduction: Antiretroviral therapy has reduced HIV/AIDS related mortality. However, unlike in developed countries, little is documented about it’s the impact on Health-related quality of life (HRQoL) in developing countries, where HRQoL is rarely assessed. This highlights a deficiency in assessment of health status of HIV infected people in clinical setting where ART scale-up continues to expand. General objective: To measure HRQoL among HIV-infected adults attending an HIV clinic in Kampala using the medical outcome study HIV tool and to assess the reliability, convergent and discriminant validity of this tool in this setting Specific Objectives: 1) To measure reliability, convergent and discriminant validity of the adopted MOS-HIV tool in assessing HRQoL in an urban HIV clinic 2) To compare scores of HRQoL scales between ART-experienced and ART-Naïve individuals attending an urban HIV clinic using the MOS-HIV tool 3) To determine factors associated with HRQoL among ART-experienced and ART-Naive patients attending an urban HIV clinic Study Design: Across sectional study with a random sample of 188 participants. Results: Overall, ART-experienced patients had higher HRQoL scores than ART-Naïve patients. Reliability coefficients were >0.8 for all scales and the attenuated correlations were < 0.85confirming discriminant and convergent validity. The expected average difference between an ART-Experienced patient who had attained post secondary education and one with pre secondary education was 4.78 for PHS score and 5.42 for MHS score. The expected average difference in the MHS score between an ART-Naive patient who had employment and one who did not have employment was 4.47. The expected average difference in PHS and MHS for an HIV infected adult was between 6.5 and 8.4 holding other variables in the model constant. Conclusion: Education level, presence of symptoms and employment status are associated with HRQoL. The MOS-HIV tool is a reliable and valid tool to measure HRQoL among HIV-infected adults in Uganda.