title: Health-related quality of life in veterans and nonveterans with HIV/AIDS.
abstract: OBJECTIVE
  To compare health-related quality of life (HRQoL) between patients receiving care in Veterans Administration (VA) settings (veterans) and non-VA settings (nonveterans), and to explore determinants of HRQoL and change in HRQoL over time in subjects living with HIV/AIDS.
  
  
  METHODS
  One hundred veterans and 350 nonveterans with HIV/AIDS from 2 VA and 2 university-based sites in 3 cities interviewed in 2002 to 2003 and again 12 to 18 months later.
  
  
  METHODS
  We assessed health status (functional status and symptom bother), health ratings, and health values (time tradeoff [TTO] and standard gamble [SG] utilities). We also explored bivariate and multivariable associations of HRQoL measures with a number of demographic, clinical, spiritual/religious, and psychosocial characteristics.
  
  
  RESULTS
  Compared with nonveterans, the veteran population was older (47.7 vs 42.0 years) and consisted of a higher proportion of males (97% vs 83%), of participants with a history of injection drug use (23% vs 15%), and of subjects with unstable housing situations (14% vs 6%; P<.05 for all comparisons). On scales ranging from 0 (worst) to 100 (best), veterans reported significantly poorer overall function (mean [SD]; 65.9 [17.2] vs 71.9 [16.8]); lower rating scale scores (67.6 [21.7] vs 73.5 [21.0]), lower TTO values (75.7 [37.4] vs 89.0 [23.2]), and lower SG values (75.0 [35.8] vs 83.2 [28.3]) than nonveterans (P<.05 for all comparisons); however, in multivariable models, veteran status was only a significant determinant of SG and TTO values at baseline. Among other determinants that were associated with multiple HRQoL outcomes in baseline and follow-up multivariable analyses were: symptom bother, overall function, religiosity/spirituality, depressive symptoms, and financial worries.
  
  
  CONCLUSIONS
  Veterans reported significantly poorer HRQoL than nonveterans, but when controlling for other factors, veteran status was only a significant determinant of TTO and SG health values at baseline. Correlates of HRQoL such as symptom bother, spirituality/religiosity, and depressive symptoms could be fruitful potential targets for interventions to improve HRQoL in patients with HIV/AIDS.
authors.affiliation: Cincinnati VA Medical Center, Cincinnati, OH, USA. joemrus@hotmail.com
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Mrus
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Leonard
authors.forename: Michael S
authors.initials: MS
authors.lastname: Yi
authors.forename: Susan N
authors.initials: SN
authors.lastname: Sherman
authors.forename: Shawn L
authors.initials: SL
authors.lastname: Fultz
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012069:Religion and Psychology; D012649:Self Concept; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data*