Treatments continue to improve but adjustment challenges remain: self-management and wellbeing in people with HIV

Abstract

Background: Combination antiretroviral treatment (cART) has made HIV infection a chronic, manageable condition. Simultaneously, attention for psychological challenges in people with HIV has however rapidly diminished in research and practice. This study assessed wellbeing in a contemporary sample of people with HIV and examined associations with HIV self-management, biographical, illness, social, economic and psychological variables. Method: A self-selected sample of 360 people with HIV in Australia participated in a national online survey. Reflecting the local epidemic, participants were mostly men (96.4%) and self-identified as gay (90.3%). Average age was 46.7 years (SD=10.9). Participants completed a self-report questionnaire assessing socio-demographic characteristics; health status and treatment of HIV; income and financial strain; social support and social stigma; beliefs regarding cART; HIV self-management; and depression. Results: Participants’ scores on the PHQ-9 indicated that 26.4% had experienced major depression in the past two weeks. Participants’ scored positively on the 5-point Wallston et al. HIV self-management scale (Mean=3.98; SD=0.71). Logistic regression analysis showed independent negative associations of depression with HIV self-management (O.R.=0.54, p<.05), quality of life (O.R.=0.44, p<.001), subjective health (O.R.=0.61, p=.01) and financial strain (O.R.=0.38, p<.05). Conclusion: Major depression was experienced by a quarter of participants in this study of HIV-positive people with access to state-of-the-art HIV treatment. This suggests that while life expectancy of people with HIV is approaching that of non-infected people, their wellbeing may not. Findings underscore the continued importance of adjustment support for people with HIV, including the promotion of self-management and alleviating financial strain from living with chronic HIV.