Family support,discrimination,and quality of life among ART-treated HIV-infected patients:a two-year study in China

Background:By September 2016,approximately 653,865 people in China were living with HIV/AIDS(PLWHA)and 492,725 people were receiving antiretroviral therapy(ART).PLWHA frequently experience discrimination in all domains of their personal and social lives.The World Health Organization includes discrimination in its list of social determinants of health factors that have been linked to poor physical and psychological health.This paper identifies the family support enjoyed and discrimination faced by people infected with HIV and examines the effect they have on patients’quality of life(QOL)as they undergo ART in China.Methods:We conducted this observational cohort study of ART-treated patients with HIV in Guangxi Province using a questionnaire survey at baseline,6,12,and 24 months,starting in 2010.Descriptive analysis was used to describe the demographic characteristics(e.g.,age,sex,educational level,marital status,and employment status)of participants.Generalized estimating equations(GEE)were employed to examine the relationships between family support,discrimination,and QOL.Results:In the study,90.4%(n=281)of patients received family support at baseline,here defined as the initiation of ART,91.8%(n=244)received family support 6 months into ART,95.5%(n=220)at 12 months,and 94.3%(n=230)at 24 months.The proportion of patients who did not feel discriminated against by their families was 87.2%(n=274)at baseline,90.4%(n=229)6 months into ART,90.0%(n=210)at 12 months,and 94.5%(n=219)at 24 months.Patients’overall QOL scores were positively associated with having received family support(OR=2.74,P=0.040,95%CI:1.68-4.47),not feeling discriminated against by their families(OR=1.3,P=0.041,95%CI:1.07-1.59)or discrimination from patients themselves,including never experiencing fear of abandonment by family(OR=2.05,P=0.025,95%CI:1.49-2.82).Conclusions:Family support along with no or minimal discrimination was found to contribute to QOL among people infected with HIV.Their overall QOL tended to improve significantly as ART continued.This suggests that strategies meant to improve and strengthen family support,care for PLWHA,and promote HIV screening among high-risk populations should be explored by both policy makers and researchers.

Health related behaviors among HIV-infected people who are successfully linked to care:an institutional-based crosssectional study

Background:By the end of October 2019,there were 958 thousand people were reported living with HIV/AIDS in China.Unhealthy lifestyle factors,such as smoking,drinking alcohol,using illicit drugs and no physical activity have been found to mitigate the positive impact of antiretroviral therapy(ART)on viral load and HIV-related quality of life.Moreover,risky sexual behavior among HIV-positive persons places their partners at risk for HIV transmission and other sexually transmitted infections.The aim of the study is to determine the prevalence of unhealthy behavior of people living with HIV/AIDS and related influencing factors,particularly those that are closely connected with HIV infection and ART effects.Methods:An institutional based cross-sectional study design was used to collect data from people living with HIV/AIDS(PLWHA)in Beijing and Yunnan Province.The following information was included in the questionnaire survey:social-demographic characteristics,health behavior information,sexual risk behaviors.Binary logistic regression model was conducted to analyze the influencing factors of unhealthy general health behaviors and risky sexual behaviors.Results:In total,2575 PLWHA were included in the study and 78.3%(2017/2575)were male.For the general health behaviors,34.2%(987/2544)smoke;33.8%(870/2575)drank alcohol and 2.3%(49/2134)reported the use of illicit drugs in the previous 6 months.From the sexual behaviors perspective,59.0%(1519/2575)had sex in the previous 6 months.Among people who had sex,92.0%(1398/1519)had fixed sexual partners.Among those with no fixed sexual partner,38.0%(46/121)had more than three partners.Among men who had sex,34.7%(448/1292)reported having sex with men in the previous 6 months and 167%(75/448)of these had group sexual activity.Among participants,72.2%(1053/1458)used condoms every time they had sex while 6.4%(94/1458)of people never used condom.Male people living with HIV/AIDS were more likely to have sexual risk behaviors(adjusted odds ratio[OR]=2.208,95%confidence interval[CI]:1.147-4.252)and unhealthy general health behaviors(adjusted OR=2.029,95%CI:1.480-2.783).The odds of higher risk sexual behaviors was 1.546 times(95%CI:1.302-1.827,P=0.001)greater among participants who drank alcohol compared with their non-drinking counterparts.Conclusions:PLWHA is a group that is vulnerable to problematic health behaviors,especially for men who were more likely to drink alcohol,have more sexual partners,more sexual risk behaviors including group sexual activity,not using condoms and using drugs.Therefore,interventions focusing on gender-specific risk behaviors reduction for people living with HIV/AIDS are now necessary to control the spread of HIV infection and improve the efficacy of antiviral treatment.