title: HIV+ caregivers and HIV+ non-caregivers: differences in sociodemographics, immune functioning, and quality-of-life.
abstract: OBJECTIVE
  To examine a cohort of HIV+ study participants, who are caregivers (CGs) and non-caregivers (NCGs), to determine whether differences exist across their sociodemographic backgrounds, immune functioning, and quality-of-life (i.e., symptom distress, physical, and mental quality-of-life).
  
  
  METHODS
  A secondary analysis of the cross-sectional subset of the population-based Collaborations HIV Outcomes Research US Cohort (CHORUS). Sample consists of 5521 HIV+ adults; median age 43 years (SD 8.7); 88.6% male; 70.7% non-Hispanic White, 17.6% African-American, and 7.8% Hispanic. Measures include the HIV Symptom Distress Scale and the SF-12. Analytical models included t-tests and multivariate linear regression.
  
  
  RESULTS
  HIV+ CGs have lower educational attainment than HIV+ NCGs (p=0.02). Seropositive CGs also experience greater HIV symptom distress (adjusted p<0.006) and poorer physical quality-of-life (adjusted p<0.001) than their seropostive NCG counterparts.
  
  
  CONCLUSIONS
  HIV+ CGs may require different supportive services than HIV+ NCGs, suggesting a need to develop tailored interventions to address modifiable factors, such as lower education and poor physical health. Both of these factors have been associated with suboptimal antiretroviral adherence, suggesting a role for the routine screening of adherence predictors amongst HIV+ CGs. These findings may have more relevance in resource-poor settings where the prevalence of HIV is higher, with a likely growing population of informal and family CGs infected with HIV.
authors.affiliation: Center for Multicultural Mental Health Research, Cambridge Health Alliance & Harvard Medical School, Somerville, MA, USA. linda.marc@post.harvard.edu
authors.forename: Linda G
authors.initials: LG
authors.lastname: Marc
authors.forename: Mathew
authors.initials: M
authors.lastname: Zerden
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ferrando
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Testa
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014481:United States