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. 2023 Apr 11;21(1):25.
doi: 10.1186/s12962-023-00434-y.

Associations between treatment burden, self-reported treatment qualities, antiretroviral therapy obtainment, and health-related quality of life among Ugandan PLWH

Ming Guan  1   2   3 , Hongyi Guan  4
Affiliations

Associations between treatment burden, self-reported treatment qualities, antiretroviral therapy obtainment, and health-related quality of life among Ugandan PLWH

Ming Guan et al. Cost Eff Resour Alloc. .

Abstract

Background: Understanding related risk factors of health-related quality of life (HRQoL) could avoid treatment failure and provide an insight of personalized treatment approach among people living with HIV/AIDS (PLWH). The objective of this study was to identify factors associated with self-reported treatment qualities and domains of health-related quality of life (HRQoL) among PLWH in Uganda.

Method: Data were from "Life on antiretroviral therapy: People's adaptive coping and adjustment to living with HIV as a chronic condition in Wakiso District, Uganda" in English. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was used to assess the HRQoL of 263 PLWH in the sample. Considering variance inflation factors, multiple regression analyses were performed to assess the associations between demographic factors, ART obtainment, treatment burden, and self-reported treatment qualities, associations between demographic factors, self-reported treatment qualities, and HRQoL, and association between ART obtainment and HRQoL. Controlling for the confounding effects, several regression anatomies were employed to explore the associations between self-reported treatment qualities and six domains of HRQoL.

Results: In the sample, the geographical distribution were urban (5.70%), semi-urban (37.26%), and rural (57.03%). 67.30% of the participants were females. The mean age of the sample was 39.82 years (standard deviation = 9.76) ranging from 22 to 81 years. Multiple logistic regressions reported statistically significant associations of distance to ART facility with self-reported quality of services, advice, manners, and counseling, statistically significant association between self-reported manners quality and four domains of HRQoL, and statistically significant association between TASO membership and domains of HRQoL. Plots from regression anatomies reported that self-reported treatment qualities had statistically significant associations with six domains of HRQoL.

Conclusions: Treatment burden, self-reported treatment qualities, ART obtainment, and TASO were possible determinants of individual domains of HRQoL among PLWH in Uganda. PLWH's HRQoL might be improved by promoting medical quality and optimizing ART obtainment in the healthcare providers' practice. Findings in this study had important implications for the redesign of clinical guidelines, healthcare delivery, and health care co-ordination among PLWH globally.

Keywords: ART obtainment; PLWH; Quality of life; Self-reported treatment qualities; Treatment burden; Uganda.

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Conflict of interest statement

The authors declared no potential conflict of interest with respect to the research, authorship and/or publication of this article.

Figures

Fig. 1
Fig. 1
Composite graph of physical QOL Note: Regression lines: Solid = Multivariate, Dashed = Bivariate. Scatterplot: Dots = Transformed data, Triangles = Original data. VIFs of age, sex, enough meals daily, TASO membership, number of daily pills, medicine change, ART frequency, ART duration, distance to ART facility, traveling time to ART facility, visiting cost to ART facility, waiting time at ART facility, self-reported services quality, self-reported advice quality, self-reported manners quality, and self-reported counseling quality were 1.19, 1.17, 1.06, 1.78, 1.11, 1.32, 1.87, 1.19, 1.65, 2.22, 1.75, 1.13, 1.67, 1.31, 2.14, and 1.99. Mean VIF = 1.54
Fig. 2
Fig. 2
Composite graph of psychological QOL Note: Regression lines: Solid = Multivariate, Dashed = Bivariate. Scatterplot: Dots = Transformed data, Triangles = Original data. VIFs of age, sex, enough meals daily, TASO membership, number of daily pills, medicine change, ART frequency, ART duration, distance to ART facility, traveling time to ART facility, visiting cost to ART facility, waiting time at ART facility, self-reported services quality, self-reported advice quality, self-reported manners quality, and self-reported counseling quality were 1.19, 1.17, 1.06, 1.78, 1.11, 1.32, 1.87, 1.19, 1.65, 2.22, 1.75, 1.13, 1.67, 1.31, 2.14, and 1.99. Mean VIF = 1.54
Fig. 3
Fig. 3
Composite graph of social QOL Note: Regression lines: Solid = Multivariate, Dashed = Bivariate. Scatterplot: Dots = Transformed data, Triangles = Original data. VIFs of age, sex, enough meals daily, TASO membership, number of daily pills, medicine change, ART frequency, ART duration, distance to ART facility, traveling time to ART facility, visiting cost to ART facility, waiting time at ART facility, self-reported services quality, self-reported advice quality, self-reported manners quality, and self-reported counseling quality were 1.19, 1.17, 1.06, 1.78, 1.11, 1.32, 1.87, 1.19, 1.65, 2.22, 1.75, 1.13, 1.67, 1.31, 2.14, and 1.99. Mean VIF = 1.54
Fig. 4
Fig. 4
Composite graph of environment QOL Note: Regression lines: Solid = Multivariate, Dashed = Bivariate. Scatterplot: Dots = Transformed data, Triangles = Original data. VIFs of age, sex, enough meals daily, TASO membership, number of daily pills, medicine change, ART frequency, ART duration, distance to ART facility, traveling time to ART facility, visiting cost to ART facility, waiting time at ART facility, self-reported services quality, self-reported advice quality, self-reported manners quality, and self-reported counseling quality were 1.19, 1.17, 1.06, 1.78, 1.11, 1.32, 1.87, 1.19, 1.65, 2.22, 1.75, 1.13, 1.67, 1.31, 2.14, and 1.99. Mean VIF = 1.54
Fig. 5
Fig. 5
Composite graph of general QOL Note: Regression lines: Solid = Multivariate, Dashed = Bivariate. Scatterplot: Dots = Transformed data, Triangles = Original data. VIFs of age, sex, enough meals daily, TASO membership, number of daily pills, medicine change, ART frequency, ART duration, distance to ART facility, traveling time to ART facility, visiting cost to ART facility, waiting time at ART facility, self-reported services quality, self-reported advice quality, self-reported manners quality, and self-reported counseling quality were 1.19, 1.17, 1.06, 1.78, 1.11, 1.32, 1.87, 1.19, 1.65, 2.22, 1.75, 1.13, 1.67, 1.31, 2.14, and 1.99. Mean VIF = 1.54
Fig. 6
Fig. 6
Composite graph of general health Note: Regression lines: Solid = Multivariate, Dashed = Bivariate. Scatterplot: Dots = Transformed data, Triangles = Original data. VIFs of age, sex, enough meals daily, TASO membership, number of daily pills, medicine change, ART frequency, ART duration, distance to ART facility, traveling time to ART facility, visiting cost to ART facility, waiting time at ART facility, self-reported services quality, self-reported advice quality, self-reported manners quality, and self-reported counseling quality were 1.19, 1.17, 1.06, 1.78, 1.11, 1.32, 1.87, 1.19, 1.65, 2.22, 1.75, 1.13, 1.67, 1.31, 2.14, and 1.99. Mean VIF = 1.54
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