HIV Symptom Clusters are Similar Using the Dimensions of Symptom Occurrence and Distress

Area of Science:

• Clinical Medicine
• Public Health
• Psychology

Background:

• People living with HIV (PLWH) experience significant symptom burden despite advances in antiretroviral therapy.
• Symptom management remains a critical aspect of care for PLWH.

Purpose of the Study:

• To compare symptom clusters derived from symptom occurrence rates versus distress ratings in PLWH.
• To determine if the number and types of symptom clusters differ based on the chosen metric.

Main Methods:

• Utilized data from 2,000 PLWH across six national HIV centers.
• Employed exploratory factor analysis on the 20-item HIV Symptom Index, analyzing both symptom occurrence and distress scores.
• Examined symptom clusters including gastrointestinal, psychological, pain, and body image.

Main Results:

• Identified four consistent symptom clusters (gastrointestinal, psychological, pain, body image) regardless of whether occurrence rates or distress ratings were used.
• The psychological, pain, and body image clusters comprised identical symptoms across both dimensions.
• The gastrointestinal cluster showed variations, with four symptoms loading on occurrence and six on distress.

Conclusions:

• Symptom cluster identification in PLWH is robust across occurrence and distress metrics.
• These findings support the utility of symptom clusters for developing targeted interventions addressing co-occurring symptoms in PLWH.