The impact of HIV on maternal quality of life in Uganda
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Medical Research Council, Clinical Trials Unit (MRC-CTU), London, United Kingdom; University of Oxford, Oxford, United Kingdom; University of Oxford, Health Services Research Unit, Oxford, United Kingdom; St. Francis Hospital Nsambya, Kampala, Uganda; Medical Research Council, Clinical Trials Unit (MRC-CTU), 222 Euston Road, London, NW1 2DA, United Kingdom
To study the effect of HIV infection on quality of life (QOL) during pregnancy and puerperium, QOL was measured in a cohort study at St. Francis Hospital Nsambya, Kampala, Uganda. Dartmouth COOP charts were administered to 132 HIV-positive and 399 HIV-negative women at 36 weeks of pregnancy and six weeks post-partum. Responses were coded from 0 = best health-status to 4 = worst health-status and scores of 3-4 defined as poor. Odds ratios (OR) (95% confidence intervals(CI)) for poor scores were calculated and independent predictors of poor QOL examined using logistic regression. In pregnancy, HIV-positive women were more likely to have poor scores in feelings: OR = 3.2(1.9-5.3), daily activities: OR = 2.8(1.4-5.5), pain: OR = 2.1(1.3-3.5), overall health: OR = 1.7(1.1-2.7) and QOL: OR = 7.2(3.6-14.7), all p = ≤ 0.01. Differences in physical fitness, change in health, social activities and social support were not statistically significant (all p >0.2). HIV infection was independently associated with poor QOL: OR = 8.5(3.8-19). Findings in puerperium were similar to those in pregnancy except more HIV-positive women had poor scores in social activities: OR = 2.5(1.4-4.7) and change in health: OR = 5.4(2-14.5) and infant death also predicted poor QOL: OR = 6.7(2.4-18.5). The findings reflect HIV's adverse impact on maternal QOL and the need for interventions to alleviate this infection's social and emotional effects. © 2006 Taylor & Francis.
adult; article; cohort analysis; comparative study; confidence interval; controlled study; daily life activity; female; fitness; health status; human; Human immunodeficiency virus; Human immunodeficiency virus infection; logistic regression analysis; major clinical study; maternal welfare; pain assessment; pregnancy; priority journal; puerperium; quality of life; risk; scoring system; social behavior; social support; Uganda; Adult; Female; Health Status; HIV Infections; Humans; Pregnancy; Pregnancy Complications, Infectious; Puerperal Disorders; Quality of Life; Uganda