Abstract:
BACKGROUND: Health Related Quality of Life (HRQoL) is an important outcome in times of Highly
Active Antiretroviral Treatment (HAART). We compared the HRQoL of HIV positive patients
receiving HAART with those awaiting treatment in public sector facilities in the Free State province
in South Africa.
METHODS: A stratified random sample of 371 patients receiving or awaiting HAART were
interviewed and the EuroQol-profile, EuroQol-index and Visual Analogue Scale (VAS) were
compared. Independent associations between these outcomes and HAART, socio-demographic,
clinical and health service variables were estimated using linear and ordinal logistic regression,
adjusted for intra-clinic clustering of outcomes.
RESULTS: Patients receiving HAART reported better HRQoL for 3 of the 5 EuroQol-dimensions,
for the VAS score and for the EuroQol index in bivariable analysis. They had a higher mean
EuroQol index (0.11 difference, 95% confidence interval [CI] 0.04; 0.23), and were more likely to
have a higher index (odds ratio 1.9, 95% CI 1.1; 1.3), compared to those awaiting HAART, in
multivariate analysis. Higher mean VAS scores were reported for patients who were receiving
HAART (6.5 difference, 95% CI 1.3; 11.7), were employed (9.1, 95% CI 4.3; 13.7) or were female
(4.7, 95% CI 0.79; 8.5).
CONCLUSION: HAART was associated with improved HRQoL in patients enrolled in a public sector
treatment program in South Africa. Our finding that the EuroQol instrument was sensitive to
HAART supports its use in future evaluation of HIV/AIDS care in South Africa. Longitudinal studies
are needed to evaluate changes in individuals' HRQoL.
