A Study on the Quality of Life and Economic Burden Among People Living With HIV/AIDS and Attending a Tertiary Care Hospital in Jharkhand, India

Background AIDS, a potentially life-threatening disease caused by a retrovirus known as human immunodeficiency virus (HIV), has evolved from a mysterious illness to a global pandemic, affecting tens of millions of people. HIV/AIDS poses an increasing threat to the health of the population and causes further socioeconomic loss for people, communities and governments in many countries and drastically affects the quality and standard of life. Very few studies have used the World Health Organization Quality of Life HIV Brief Scale (WHOQOL-HIV BREF) instrument in people living with HIV and AIDS (PLWHA). The study aims to assess the quality of life (QOL) and economic burden of PLWHA and to determine various factors affecting their QOL. Methods The study was an institution-based cross-sectional study at an Anti-Retroviral Therapy Centre of a tertiary care hospital in the state of Jharkhand in India from June 2018 to November 2020. The study population consists of HIV/AIDS patients aged 18 years or older and who had been diagnosed as HIV positive and were on antiretroviral therapy (ART) for more than a month. Systematic random sampling was used to recruit 216 patients for this study. Data collected using the semi-structured questionnaire, WHOQOL-100 and WHOQOLHIV-BREF for assessing QOL and a self-designed, semi-structured and pretested proforma was used to assess the economic burden of PLWHA. The data were analysed by using the IBM Statistical Package for Social Science (SPSS) version 20.0 (IBM Corp, Armonk, NY, USA). Frequency tables were generated to see the distribution of variables. Student's t-distribution test was performed to assess the association between the mean score of QOL and dichotomous variables. One-way analysis of variance (ANOVA) was used for the variables with multiple categories. Correlation and multiple linear regression were implemented to see the association between economic burden and QOL. For all statistical analyses, a p-value <0.05 was considered significant. Results The mean age (±standard deviation (SD)) of 216 patients was found to be 40.48 (±11.87) years. In this study, participants reported a QOL score mean (±SD) of 55.48 (±8.006) for the physical domain, 64.87 (±6.920) for the psychological domain, 54.95 (±5.308) for the level of independence domain, 60.67 (±5.586) for the social relationship domain, 67.98 (±3.940) for the environmental domain and 49.42 (±5.202) for the spiritual/religious/personal beliefs (SRPB) domain. The total QOL score was found to be 57.79 (±3.248). The total mean economic burden was assessed to be INR 36,182.94 (±5606.98) per month. The study showed a significant association between the independent variables - total medical costs (p-value=0.022), loss of wages (p-value=0.005) and total economic burden (p-value =0.004) - and the total QOL scores. Conclusion Economic burden plays an important part in affecting the lives of people with HIV/AIDS. There is a need for financial intervention and rehabilitation programs catering to the needs of PLWHA, which will not only give them a sense of security but also lead them to have a community where they will feel welcome and be satisfied with their life.