Some patients diagnosed with HIV experience improved outlook on life

CINCINNATI -- A new study from researchers at the University of Cincinnati (UC) and the Cincinnati Department of Veterans Affairs Medical Center reaffirms that some patients with HIV experience an improved quality of life following their diagnosis.

These findings are being published in the November issue of the journal AIDS Patient Care and STDs.

Joel Tsevat, MD, principal investigator of the study, and a team of researchers conducted two sets of interviews and completed chart reviews of 347 HIV outpatients from three U.S. cities in 2002-2004.

"Approximately 1.1 million Americans are infected with HIV," says Tsevat, a physician and researcher in the department of internal medicine. "Substantial increases in life expectancy for people with HIV have sharpened the focus on their quality of life. Although many studies have examined quality of life in patients with HIV, little information is available comparing quality of life with HIV versus quality of life before being diagnosed."

Researchers looked at demographic and clinical characteristics of patients, HIV-specific health status, symptoms, health concerns, spirituality/religion, social support, self-perception and levels of optimism.

"In two interviews, conducted a year to 18 months apart, patients compared their current life with life before being diagnosed with HIV," he says. "We found that many patients said their life is better than it was before their diagnosis, although results of such comparisons often change over time."

Results after the first interview showed that 109 patients (31 percent) said their lives were better after diagnosis, 98 (28 percent) said they were worse, and the remainder -- 140 patients -- said their lives were about the same or that they were undecided.

After the second interview, approximately one-fifth of patients changed their answers to indicate life improvement after diagnosis; one-sixth changed answers to reflect a feeling of life deterioration.

"Change in perception for the better was positively associated with religious coping, whereas change in perception for the worse was associated with factors such as the study site, sexual orientation, shorter duration of HIV, lower levels of spirituality and lower positive religious coping scores," Tsevat says. "The two main factors associated with the feeling that life has improved, relative to pre-diagnosis, were optimism and spirituality."

But he continues that additional studies are needed to look further into these factors and how they relate to HIV and other chronic illnesses.

"To see that patients not only cope and adapt to such a serious illness but can actually reach a point where they believe that life is better than before being diagnosed with HIV offers hope for numerous people infected with a virus that once meant only suffering and death," he says. "Future work should explore whether interventions can improve quality of life among those with a less favorable view of life with HIV."

This study was funded by the Health Services Research and Development Service of the Department of Veterans Affairs and by the National Center for Complementary and Alternative Medicine of the National Institutes of Health.