QUALITY OF LIFE OF HIV PATIENTS TWO YEARS INTO TREATMENT IN A

COMMUNITY-BASED ANTIRETROVIRAL THERAPY PROGRAM IN WESTERN

UGANDA

Catherine Paulsen1, Arif Alibhai1, Walter Kipp1, L. Duncan Saunders1,

Joseph Konde-Lule2, Gian S Jhangri1, Tom Rubaale3

1University of Alberta, 2Makerere University, 3Kabarole Health Department

Kabarole District

Southwestern Uganda

Primarily subsistence farmers

Adult HIV Prevalence: Uganda: 6.5% Kabarole District:

11.6%

CBART Program

Community-Based Antiretroviral Therapy (CBART) Program Improve access to treatment Clinical outcomes comparable to best practice

hospital Health related quality of life also increased after one

year of treatment

The aim of this study was to extend the analyses of health related quality of life in CBART patients to the two-year period after the initiation of treatment.

Methods

A Rutooro translated version of the MOS-HIV survey, adapted for Uganda, was administered at baseline, year one, and year two for 122 of 185 CBART patients

Changes in MOS-HIV Physical Health Summary (PHS) and Mental Health Summary (MHS) scores, as well as individual domain scores, were assessed over the two-year period.

Means were compared using paired t-tests, and p-

values were adjusted using the Bonferroni correction.

Baseline Year 1 Year 230

35

40

45

50

55

PH

S

0

≈

Mean Physical Health Summary Score

Baseline Year 1 Year 230

35

40

45

50

55

MH

S0

≈

Mean Mental Health Summary Score

Changes in Mean PHS & MHS

Changes in MOS-HIV Domain Scores

Domain Baseline ScoreDifference between

Baseline & Year 1Difference between

Year 1 & Year 2

General Health Perceptions 37.2 9.1 ** 1.2

Pain 52.9 13.8 ** -4.5

Quality of Life 55.3 10.8 ** -2.7

Role Functioning 66.0 18.0 ** 9.0 *

Social Functioning 65.1 15.4** 1.1

Vitality 54.0 11.0** -0.1

Mental Health 62.1 8.6 ** 0.7

Health Distress 60.9 12.9 ** -0.9

Cognitive Functioning 72.6 10.8 ** 2.6

Health Transition 74.2 11.5 ** -6.6 *

Physical Functioning 64.7 20.1 ** 0.4

* Indicates a p-value < 0.05; ** Indicates a p-value <0.001

Type of Change in PHS & MHS Score

Baseline - Year 1

Baseline - Year 2

0

10

20

30

40

50

60

Change in Physical Health Score

Decrease

No Change

Increase

Percent(%)

Baseline - Year 1 Baseline to Year 20

10

20

30

40

50

60Change in Mental Health

Score Decrease

No Change

IncreasePercent

(%)

Future Directions

Linear mixed models will be used to better understand the variability in health related quality of life over the two year period

Conclusions

Mean physical and mental health summary scores, and most domain scores increased between baseline and year one, and were stable between year one and year two.

However, the aggregate scores mask the fact that approximately only 50% of patients had clinically significant (≥5 units) increases in their PHS and MHS scores.

Acknowledgements

We would like to acknowledge the support of Leah Martin, Ashley Wynne, Yan Chen, and the many dedicated staff and research assistants in Fort Portal, Uganda. This study was funded by a Canadian Institutes for Health Research (CIHR) grant.

References

1. Kipp W, Konde-Lule J, Saunders LD, Alibhai A, Houston S, Rubaale T, Senthilselvan A, Okech-Ojony J.(2012). Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort. PLoS One. 7(7):e40902. doi: 10.1371/journal.pone.0040902. Epub 2012 Jul 17.

2. Alibhai A, Martin LJ, Kipp W, Konde-Lule J, Saunders LD, Rubaale T, Houston S, Okech-Ojony J. (2010). Quality of life of HIV patients in a rural area of western Uganda: impact of a community-based antiretroviral treatment program. Current HIV Research. 8(5):370-378.

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