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Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial

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Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa : a cross-sectional baseline survey of the HPTN 071 (PopART) trial. / HPTN 071 (PopART) Study Team.

In: The Lancet Global Health, Vol. 5, No. 11, 01.11.2017, p. e1133-e1141.

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HPTN 071 (PopART) Study Team 2017, 'Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial', The Lancet Global Health, vol. 5, no. 11, pp. e1133-e1141. https://doi.org/10.1016/S2214-109X(17)30367-4

APA

HPTN 071 (PopART) Study Team (2017). Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial. The Lancet Global Health, 5(11), e1133-e1141. https://doi.org/10.1016/S2214-109X(17)30367-4

Vancouver

HPTN 071 (PopART) Study Team. Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial. The Lancet Global Health. 2017 Nov 1;5(11):e1133-e1141. https://doi.org/10.1016/S2214-109X(17)30367-4

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HPTN 071 (PopART) Study Team. / Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa : a cross-sectional baseline survey of the HPTN 071 (PopART) trial. In: The Lancet Global Health. 2017 ; Vol. 5, No. 11. pp. e1133-e1141.

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@article{7c7e310d78d34605a5b07d1268e7355e,
title = "Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial",
abstract = "Background The life expectancy of HIV-positive individuals receiving antiretroviral therapy (ART) is approaching that of HIV-negative people. However, little is known about how these populations compare in terms of health-related quality of life (HRQoL). We aimed to compare HRQoL between HIV-positive and HIV-negative people in Zambia and South Africa. Methods As part of the HPTN 071 (PopART) study, data from adults aged 18–44 years were gathered between Nov 28, 2013, and March 31, 2015, in large cross-sectional surveys of random samples of the general population in 21 communities in Zambia and South Africa. HRQoL data were collected with a standardised generic measure of health across five domains. We used β-distributed multivariable models to analyse differences in HRQoL scores between HIV-negative and HIV-positive individuals who were unaware of their status; aware, but not in HIV care; in HIV care, but who had not initiated ART; on ART for less than 5 years; and on ART for 5 years or more. We included controls for sociodemographic variables, herpes simplex virus type-2 status, and recreational drug use. Findings We obtained data for 19 750 respondents in Zambia and 18 941 respondents in South Africa. Laboratory-confirmed HIV status was available for 19 330 respondents in Zambia and 18 004 respondents in South Africa; 4128 (21{\%}) of these 19 330 respondents in Zambia and 4012 (22{\%}) of 18 004 respondents in South Africa had laboratory-confirmed HIV. We obtained complete HRQoL information for 19 637 respondents in Zambia and 18 429 respondents in South Africa. HRQoL scores did not differ significantly between individuals who had initiated ART more than 5 years previously and HIV-negative individuals, neither in Zambia (change in mean score −0·002, 95{\%} CI −0·01 to 0·001; p=0·219) nor in South Africa (0·000, −0·002 to 0·003; p=0·939). However, scores did differ between HIV-positive individuals who had initiated ART less than 5 years previously and HIV-negative individuals in Zambia (−0·006, 95{\%} CI −0·008 to −0·003; p<0·0001). A large proportion of people with clinically confirmed HIV were unaware of being HIV-positive (1768 [43{\%}] of 4128 people in Zambia and 2026 [50{\%}] of 4012 people in South Africa) and reported good HRQoL, with no significant differences from that of HIV-negative people (change in mean HRQoL score −0·001, 95{\%} CI −0·003 to 0·001, p=0·216; and 0·001, −0·001 to 0·001, p=0·997, respectively). In South Africa, HRQoL scores were lower in HIV-positive individuals who were aware of their status but not enrolled in HIV care (change in mean HRQoL −0·004, 95{\%} CI −0·01 to −0·001; p=0·010) and those in HIV care but not on ART (−0·008, −0·01 to −0·004; p=0·001) than in HIV-negative people, but the magnitudes of difference were small. Interpretation ART is successful in helping to reduce inequalities in HRQoL between HIV-positive and HIV-negative individuals in this general population sample. These findings highlight the importance of improving awareness of HIV status and expanding ART to prevent losses in HRQoL that occur with untreated HIV progression. The gains in HRQoL after individuals initiate ART could be substantial when scaled up to the population level. Funding National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, National Institute of Mental Health, President's Emergency Plan for AIDS Relief, International Initiative for Impact Evaluation, the Bill & Melinda Gates Foundation.",
author = "{HPTN 071 (PopART) Study Team} and Ranjeeta Thomas and Ronelle Burger and Abigail Harper and Sarah Kanema and Lawrence Mwenge and Nosivuyile Vanqa and Nomtha Mandla and Smith, {Peter C.} and Sian Floyd and Peter Bock and Helen Ayles and Nulda Beyers and Deborah Donnell and Sarah Fidler and Richard Hayes and Katharina Hauck and James Hargreaves and Deborah Watson-Jones and Peter Godfrey-Faussett and Anne Cori and Mike Pickles and Nomtha Mandla and Blia Yang and Anelet James and Redwaan Vermaak and Nozizwe Makola and Graeme Hoddinott and Vikesh Naidoo and Virginia Bond and Musonda Simwinga and Alwyn Mwinga and Barry Kosloff and Mohammed Limbada and Justin Bwalya and Chepela Ngulube and Christophe Fraser and Susan Eshleman and Yaw Agyei and Vanessa Cummings and Denni Catalano and Lynda Emel and Lisa Bunts and Heather Noble and David Burns and Alain Kouda and Niru Sista and Ayana Moore and Rhonda White and Tanette Headen and Eric Miller",
note = "{\circledC} The Author(s) 2017",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/S2214-109X(17)30367-4",
language = "English",
volume = "5",
pages = "e1133--e1141",
journal = "The Lancet Global Health",
issn = "2214-109X",
publisher = "Elsevier BV",
number = "11",

}

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TY - JOUR

T1 - Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa

T2 - a cross-sectional baseline survey of the HPTN 071 (PopART) trial

AU - HPTN 071 (PopART) Study Team

AU - Thomas, Ranjeeta

AU - Burger, Ronelle

AU - Harper, Abigail

AU - Kanema, Sarah

AU - Mwenge, Lawrence

AU - Vanqa, Nosivuyile

AU - Mandla, Nomtha

AU - Smith, Peter C.

AU - Floyd, Sian

AU - Bock, Peter

AU - Ayles, Helen

AU - Beyers, Nulda

AU - Donnell, Deborah

AU - Fidler, Sarah

AU - Hayes, Richard

AU - Hauck, Katharina

AU - Hargreaves, James

AU - Watson-Jones, Deborah

AU - Godfrey-Faussett, Peter

AU - Cori, Anne

AU - Pickles, Mike

AU - Mandla, Nomtha

AU - Yang, Blia

AU - James, Anelet

AU - Vermaak, Redwaan

AU - Makola, Nozizwe

AU - Hoddinott, Graeme

AU - Naidoo, Vikesh

AU - Bond, Virginia

AU - Simwinga, Musonda

AU - Mwinga, Alwyn

AU - Kosloff, Barry

AU - Limbada, Mohammed

AU - Bwalya, Justin

AU - Ngulube, Chepela

AU - Fraser, Christophe

AU - Eshleman, Susan

AU - Agyei, Yaw

AU - Cummings, Vanessa

AU - Catalano, Denni

AU - Emel, Lynda

AU - Bunts, Lisa

AU - Noble, Heather

AU - Burns, David

AU - Kouda, Alain

AU - Sista, Niru

AU - Moore, Ayana

AU - White, Rhonda

AU - Headen, Tanette

AU - Miller, Eric

N1 - © The Author(s) 2017

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background The life expectancy of HIV-positive individuals receiving antiretroviral therapy (ART) is approaching that of HIV-negative people. However, little is known about how these populations compare in terms of health-related quality of life (HRQoL). We aimed to compare HRQoL between HIV-positive and HIV-negative people in Zambia and South Africa. Methods As part of the HPTN 071 (PopART) study, data from adults aged 18–44 years were gathered between Nov 28, 2013, and March 31, 2015, in large cross-sectional surveys of random samples of the general population in 21 communities in Zambia and South Africa. HRQoL data were collected with a standardised generic measure of health across five domains. We used β-distributed multivariable models to analyse differences in HRQoL scores between HIV-negative and HIV-positive individuals who were unaware of their status; aware, but not in HIV care; in HIV care, but who had not initiated ART; on ART for less than 5 years; and on ART for 5 years or more. We included controls for sociodemographic variables, herpes simplex virus type-2 status, and recreational drug use. Findings We obtained data for 19 750 respondents in Zambia and 18 941 respondents in South Africa. Laboratory-confirmed HIV status was available for 19 330 respondents in Zambia and 18 004 respondents in South Africa; 4128 (21%) of these 19 330 respondents in Zambia and 4012 (22%) of 18 004 respondents in South Africa had laboratory-confirmed HIV. We obtained complete HRQoL information for 19 637 respondents in Zambia and 18 429 respondents in South Africa. HRQoL scores did not differ significantly between individuals who had initiated ART more than 5 years previously and HIV-negative individuals, neither in Zambia (change in mean score −0·002, 95% CI −0·01 to 0·001; p=0·219) nor in South Africa (0·000, −0·002 to 0·003; p=0·939). However, scores did differ between HIV-positive individuals who had initiated ART less than 5 years previously and HIV-negative individuals in Zambia (−0·006, 95% CI −0·008 to −0·003; p<0·0001). A large proportion of people with clinically confirmed HIV were unaware of being HIV-positive (1768 [43%] of 4128 people in Zambia and 2026 [50%] of 4012 people in South Africa) and reported good HRQoL, with no significant differences from that of HIV-negative people (change in mean HRQoL score −0·001, 95% CI −0·003 to 0·001, p=0·216; and 0·001, −0·001 to 0·001, p=0·997, respectively). In South Africa, HRQoL scores were lower in HIV-positive individuals who were aware of their status but not enrolled in HIV care (change in mean HRQoL −0·004, 95% CI −0·01 to −0·001; p=0·010) and those in HIV care but not on ART (−0·008, −0·01 to −0·004; p=0·001) than in HIV-negative people, but the magnitudes of difference were small. Interpretation ART is successful in helping to reduce inequalities in HRQoL between HIV-positive and HIV-negative individuals in this general population sample. These findings highlight the importance of improving awareness of HIV status and expanding ART to prevent losses in HRQoL that occur with untreated HIV progression. The gains in HRQoL after individuals initiate ART could be substantial when scaled up to the population level. Funding National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, National Institute of Mental Health, President's Emergency Plan for AIDS Relief, International Initiative for Impact Evaluation, the Bill & Melinda Gates Foundation.

AB - Background The life expectancy of HIV-positive individuals receiving antiretroviral therapy (ART) is approaching that of HIV-negative people. However, little is known about how these populations compare in terms of health-related quality of life (HRQoL). We aimed to compare HRQoL between HIV-positive and HIV-negative people in Zambia and South Africa. Methods As part of the HPTN 071 (PopART) study, data from adults aged 18–44 years were gathered between Nov 28, 2013, and March 31, 2015, in large cross-sectional surveys of random samples of the general population in 21 communities in Zambia and South Africa. HRQoL data were collected with a standardised generic measure of health across five domains. We used β-distributed multivariable models to analyse differences in HRQoL scores between HIV-negative and HIV-positive individuals who were unaware of their status; aware, but not in HIV care; in HIV care, but who had not initiated ART; on ART for less than 5 years; and on ART for 5 years or more. We included controls for sociodemographic variables, herpes simplex virus type-2 status, and recreational drug use. Findings We obtained data for 19 750 respondents in Zambia and 18 941 respondents in South Africa. Laboratory-confirmed HIV status was available for 19 330 respondents in Zambia and 18 004 respondents in South Africa; 4128 (21%) of these 19 330 respondents in Zambia and 4012 (22%) of 18 004 respondents in South Africa had laboratory-confirmed HIV. We obtained complete HRQoL information for 19 637 respondents in Zambia and 18 429 respondents in South Africa. HRQoL scores did not differ significantly between individuals who had initiated ART more than 5 years previously and HIV-negative individuals, neither in Zambia (change in mean score −0·002, 95% CI −0·01 to 0·001; p=0·219) nor in South Africa (0·000, −0·002 to 0·003; p=0·939). However, scores did differ between HIV-positive individuals who had initiated ART less than 5 years previously and HIV-negative individuals in Zambia (−0·006, 95% CI −0·008 to −0·003; p<0·0001). A large proportion of people with clinically confirmed HIV were unaware of being HIV-positive (1768 [43%] of 4128 people in Zambia and 2026 [50%] of 4012 people in South Africa) and reported good HRQoL, with no significant differences from that of HIV-negative people (change in mean HRQoL score −0·001, 95% CI −0·003 to 0·001, p=0·216; and 0·001, −0·001 to 0·001, p=0·997, respectively). In South Africa, HRQoL scores were lower in HIV-positive individuals who were aware of their status but not enrolled in HIV care (change in mean HRQoL −0·004, 95% CI −0·01 to −0·001; p=0·010) and those in HIV care but not on ART (−0·008, −0·01 to −0·004; p=0·001) than in HIV-negative people, but the magnitudes of difference were small. Interpretation ART is successful in helping to reduce inequalities in HRQoL between HIV-positive and HIV-negative individuals in this general population sample. These findings highlight the importance of improving awareness of HIV status and expanding ART to prevent losses in HRQoL that occur with untreated HIV progression. The gains in HRQoL after individuals initiate ART could be substantial when scaled up to the population level. Funding National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, National Institute of Mental Health, President's Emergency Plan for AIDS Relief, International Initiative for Impact Evaluation, the Bill & Melinda Gates Foundation.

UR - http://www.scopus.com/inward/record.url?scp=85030671011&partnerID=8YFLogxK

U2 - 10.1016/S2214-109X(17)30367-4

DO - 10.1016/S2214-109X(17)30367-4

M3 - Article

VL - 5

SP - e1133-e1141

JO - The Lancet Global Health

JF - The Lancet Global Health

SN - 2214-109X

IS - 11

ER -