Quality of Life Among Women Living With HIV in Rural India.
Adeline M Nyamathi, Maria Ekstrand, Kartik Yadav and 7 others
PMID 28473182WHAT IT FOUND
Rural women with HIV in India reported extremely low quality of life.
Better quality of life was linked to higher immune cell counts and more social support. High internalized stigma was strongly linked to worse quality of life. Food insecurity was high but not significant in the final model.
Key findings
01In the final regression model, greater quality of life was significantly associated with higher CD4+ T cell counts and greater social support, while lower quality of life was associated with internalized stigma.
02Participants reported very low overall quality of life, with a mean score of 0.38 on a scale from 0 to 3, and minimal dispersion in responses.
03More than half of the women reported having no friends or family they could confide in, and the average rating for emotional, positive social interaction, and affectionate support was at the lowest possible point on the scale.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot determine whether low quality of life causes poor health outcomes or vice versa. The sample had extremely low quality of life and social support scores, creating a 'floor effect' that limits the ability to detect associations at higher levels of these variables. Findings may not generalize to urban populations or other cultural contexts outside rural Andhra Pradesh. ART adherence was self-reported and may be subject to recall bias or social desirability bias. The study excluded women with CD4 counts below 100 cells/mm3, who were deemed too physically weak to participate, potentially omitting the most severely ill patients.
Declared interests
The authors report no real or perceived vested interests that relate to this article that could be construed as a conflict of interest.
The easy way to misread this
Do not assume that addressing food insecurity alone will significantly improve quality of life in this population. Although food insecurity was high, it was not a statistically significant predictor in the final multivariate model, whereas social support and internalized stigma were.