Functional status and overall quality of life in a multiethnic HIV-positive population

The objective of this study was to examine the sociodemographic and behavioral variables associated with quality of life (QOL) among multiethnic, economically disadvantaged patients with HIV/AIDS. A cross-sectional survey was conducted in a large inner-city HIV/AIDS clinic serving medically indigent residents of Houston, Texas, and the surrounding area. On arrival at the clinic, patients were systematically approached and asked to complete a questionnaire, offered in both English and Spanish. Demographic characteristics, stage of disease, and behavioral variables were assessed in addition to work-role functioning and overall health-related QOL. Multiple regression analysis was conducted to assess the relationships between the variables of interest. Of 617 patients approached and asked to participate in the study, 385 (62.4%) consented to complete the questionnaire. Demographic composition of the sample was as follows: 78% male, 25% white, 44% black, and 29% Hispanic. Forty-five percent of the participants were infected through men having sex with men (MSM), 35% through heterosexual contact, and 11% through injection drug use. Racial/ethnic minorities reported significantly (p < 0.05) poorer physical functioning and work-role functioning. Participants with higher nadir CD4 cell counts (> 500 per cubic millimeter), MSM HIV exposure, and more education (beyond high school) reported better physical functioning and work-role functioning. Overall QOL and work-related functioning were significantly impaired in this patient population. The impaired functional status findings hold for every social, demographic, and behavioral subgroup examined. Findings suggest that the influence of social inequality persist even among a universally disadvantaged population.