title: Health-related quality of life in HIV-infected patients: the role of substance use.
abstract: HIV infection and substance use disorders are chronic diseases with complex contributions to health-related quality of life (HRQOL). We conducted a cross-sectional survey of 951 HIV-infected adults receiving care at 14 HIV Research Network sites in 2003 to estimate associations between HRQOL and specific substance use among HIV-infected patients. HRQOL was assessed by multi-item measures of physical and role functioning, general health, pain, energy, positive affect, anxiety, and depression. Mental and physical summary scales were developed by factor analysis. We used linear regression to estimate adjusted associations between HRQOL and current illicit use of marijuana, analgesics, heroin, amphetamines, cocaine, sedatives, inhalants, hazardous/binge alcohol, and drug use severity. Current illicit drug use was reported by 37% of subjects. Mental HRQOL was reduced for current users [adjusted beta coefficient -9.66, 95% confidence interval [(CI]) -13.4, -5.94] but not former users compared with never users. Amphetamines and sedatives were associated with large decreases in mental (amphetamines: beta = -22.8 [95% CI -33.5, -12.0], sedatives: beta = -18.6 [95% CI -26.2, -11.0]), and physical HRQOL (amphetamines: beta = -11.5 [95% CI -22.6, -0.43], sedatives: beta = -13.2 [95% CI -21.0, -5.36]). All illicit drugs were associated with decreased mental HRQOL: marijuana (beta = -7.72 [95% CI -12.0, -3.48]), non-prescription analgesics (beta = -13.4 [95% CI -20.8, -6.07]), cocaine (beta = -10.5 [95% CI -16.4, -4.67]), and inhalants (beta = -14.0 [95% CI -24.1, -3.83]). Facilitating sobriety for patients with attention to specific illicit drugs represents an important avenue for elevating HRQOL in patients living with HIV.
authors.affiliation: Department of Medicine, Oregon Health and Science University, Portland, Oregon 97239-3098, USA. korthuis@ohsu.edu
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Laurie C
authors.initials: LC
authors.lastname: Zephyrin
authors.forename: John A
authors.initials: JA
authors.lastname: Fleishman
authors.forename: Somnath
authors.initials: S
authors.lastname: Saha
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Josephs
authors.forename: Moriah M
authors.initials: MM
authors.lastname: McGrath
authors.forename: James
authors.initials: J
authors.lastname: Hellinger
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D013287:Illicit Drugs; D007407:Interviews as Topic; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs