TY - JOUR
T1 - Age, time living with diagnosed HIV infection, and self-rated health
AU - the Antiretrovirals, Sexual Transmission Risk and Attitudes (ASTRA) Study Group
AU - McGowan, J. A.
AU - Sherr, L.
AU - Rodger, A. J.
AU - Fisher, M.
AU - Miners, A.
AU - Anderson, J.
AU - Johnson, M. A.
AU - Elford, J.
AU - Collins, S.
AU - Hart, G.
AU - Phillips, A. N.
AU - Speakman, A.
AU - Lampe, F. C.
AU - McDonnell, Jeff
AU - Aderonke, Adebiyi
AU - Gilson, Richard
AU - Edwards, Simon
AU - Haddow, Lewis
AU - Gilson, Simon
AU - Broussard, Christina
AU - Pralat, Robert
AU - Wayal, Sonali
AU - Perry, Nicky
AU - Pollard, Alex
AU - Fedele, Serge
AU - Kerr, Louise
AU - Heald, Lisa
AU - Hadley, Wendy
AU - Hobbs, Kerry
AU - Williams, Julia
AU - Youssef, Elaney
AU - Richardson, Celia
AU - Groth, Sean
AU - Wilkins, Ed
AU - Clowes, Yvonne
AU - Cullie, Jennifer
AU - Murphy, Cynthia
AU - Martin, Christina
AU - George, Valerie
AU - Thompson, Andrew
AU - Mguni, Sifiso
AU - Awosika, Damilola
AU - Scourse, Rosalind
AU - Aderogba, Kazeem
AU - Osborne, Caron
AU - Cross, Sue
AU - Whinney, Jacqueline
AU - Jones, Martin
AU - O'Connell, Rebecca
AU - Nardone, Anthony
N1 - Funding Information:
All ASTRA study participants and ASTRA clinic teams are thanked for taking part in the study. Funding and support: The ASTRA study presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0608-10142). The ASTRA Study Group acknowledges the support of the NIHR, through the Comprehensive Clinical Research Network. The views expressed in this presentation are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.
Publisher Copyright:
© 2016 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objectives: An increasing proportion of people living with HIV are older adults, who may require specialized care. Adverse physical and psychological effects of HIV infection may be greatest among older people or those who have lived longer with HIV. Methods: The ASTRA study is a cross-sectional questionnaire study of 3258 HIV-diagnosed adults (2248 men who have sex with men, 373 heterosexual men and 637 women) recruited from UK clinics in 2011–2012. Associations of age group with physical symptom distress (significant distress for at least one of 26 symptoms), depression and anxiety symptoms (scores ≥ 10 on PHQ-9 and GAD-7, respectively), and health-related functional problems (problems on at least one of three domains of the Euroqol 5D-3L)) were assessed, adjusting for time with diagnosed HIV infection, gender/sexual orientation and ethnicity. Results: The age distribution of participants was: < 30 years, 5%; 30–39 years, 23%; 40–49 years, 43%; 50–59 years, 22%; and ≥ 60 years, 7%. Overall prevalences were: physical symptom distress, 56%; depression symptoms, 27%; anxiety symptoms, 22%; functional problems, 38%. No trend was found in the prevalence of physical symptom distress with age [adjusted odds ratio (OR) for trend across age groups, 0.96; 95% confidence interval (CI) 0.89, 1.04; P = 0.36]. The prevalence of depression and anxiety symptoms decreased with age [adjusted OR 0.86 (95% CI 0.79, 0.94; P = 0.001) and adjusted OR 0.85 (95% CI 0.77, 0.94; P = 0.001), respectively], while that of functional problems increased (adjusted OR 1.28; 95% CI 1.17, 1.39; P < 0.001). In contrast, a longer time with diagnosed HIV infection was strongly and independently associated with a higher prevalence of symptom distress, depression symptoms, anxiety symptoms, and functional problems (P < 0.001 for trends, adjusted analysis). Conclusions: Among people living with HIV, although health-related functional problems were more common with older age, physical symptom distress was not, and mental health was more favourable. These results suggest that a longer time with diagnosed HIV infection, rather than age, is the dominating factor contributing to psychological morbidity and lower quality of life.
AB - Objectives: An increasing proportion of people living with HIV are older adults, who may require specialized care. Adverse physical and psychological effects of HIV infection may be greatest among older people or those who have lived longer with HIV. Methods: The ASTRA study is a cross-sectional questionnaire study of 3258 HIV-diagnosed adults (2248 men who have sex with men, 373 heterosexual men and 637 women) recruited from UK clinics in 2011–2012. Associations of age group with physical symptom distress (significant distress for at least one of 26 symptoms), depression and anxiety symptoms (scores ≥ 10 on PHQ-9 and GAD-7, respectively), and health-related functional problems (problems on at least one of three domains of the Euroqol 5D-3L)) were assessed, adjusting for time with diagnosed HIV infection, gender/sexual orientation and ethnicity. Results: The age distribution of participants was: < 30 years, 5%; 30–39 years, 23%; 40–49 years, 43%; 50–59 years, 22%; and ≥ 60 years, 7%. Overall prevalences were: physical symptom distress, 56%; depression symptoms, 27%; anxiety symptoms, 22%; functional problems, 38%. No trend was found in the prevalence of physical symptom distress with age [adjusted odds ratio (OR) for trend across age groups, 0.96; 95% confidence interval (CI) 0.89, 1.04; P = 0.36]. The prevalence of depression and anxiety symptoms decreased with age [adjusted OR 0.86 (95% CI 0.79, 0.94; P = 0.001) and adjusted OR 0.85 (95% CI 0.77, 0.94; P = 0.001), respectively], while that of functional problems increased (adjusted OR 1.28; 95% CI 1.17, 1.39; P < 0.001). In contrast, a longer time with diagnosed HIV infection was strongly and independently associated with a higher prevalence of symptom distress, depression symptoms, anxiety symptoms, and functional problems (P < 0.001 for trends, adjusted analysis). Conclusions: Among people living with HIV, although health-related functional problems were more common with older age, physical symptom distress was not, and mental health was more favourable. These results suggest that a longer time with diagnosed HIV infection, rather than age, is the dominating factor contributing to psychological morbidity and lower quality of life.
KW - HIV
KW - ageing
KW - anxiety
KW - depression
KW - symptoms
KW - wellbeing
UR - http://www.scopus.com/inward/record.url?scp=85010303953&partnerID=8YFLogxK
U2 - 10.1111/hiv.12398
DO - 10.1111/hiv.12398
M3 - Article
C2 - 27385511
AN - SCOPUS:85010303953
SN - 1464-2662
VL - 18
SP - 89
EP - 103
JO - HIV Medicine
JF - HIV Medicine
IS - 2
ER -
