Psychosocial and Service Use Correlates of Health-Related Quality of Life Among a Vulnerable Population Living with HIV/AIDS

Abstract

Among people living with HIV/AIDS (PLHIV), health-related quality of life (HRQOL) is an important clinical metric of perceived well-being. Baseline data from the BEACON study (N = 383) were used to examine relationships between HRQOL and negative social support, HIV-related stigma, viral suppression, and physical and mental health service use among a vulnerable population of low-income, urban PLHIV who currently or formerly used substances, and were primarily African American. Factor analyses and structural equation modeling indicated that increases in negative social support, stigma, mental health care visits and HIV physician visits were associated with lower HRQOL, while viral suppression was associated with greater HRQOL. The association between negative social support and HRQOL suggests the importance of intervening at the dyad or network levels to shape the type of social support being provided to PLHIV. HIV-related stigma is another negative social factor that is prevalent in this sample and could be addressed by intervention. Results indicate that greater mental and physical health service use can be used to identify individuals with lower HRQOL. Therefore, findings increase an understanding of HRQOL in this understudied population and have implications for designing interventions to improve HRQOL among PLHIV.

Keywords: African American or Black; Drug use disorder; HIV-related stigma; HIV/AIDS; Health-related quality of life; Negative social support.

Figure 1

Negative social support, HIV-related stigma, health service use, and viral suppression associated with health-related quality of life among former or current drug using persons living with HIV/AIDS. (Beacon Study; N = 383). R² = .50. Model fit: CFI = .95, TLI = .94, RMSEA = .04, 90% CI = .04, .05. * p < .05,*** p ≤ .001.