244717 Health Related Quality of Life (HQOL) in Men and Women Based on HIV Status and Substance Use Disorders (SUD)

Monday, October 31, 2011

Pammie Gabrielle Renee Crawford, MPhil, SM , International Health, Health Systems Division/Department of Health Information Systems, Johns Hopkins University Bloomberg School of Public Health/Johns Hopkins University School of Medicine, Baltimore, MD
Amy B. Wisniewski, PhD , Department of Biology, Drake University, Des Moines, IA
Xiaoqiang Xu, MS , Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
Albert Wu, MD, MPH , Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Todd T. Brown, MD, PhD , Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD
Joseph Cofrancesco Jr., MD, MPH , Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
Adrian S. Dobs, MD, MHS , Division of Endocrinology and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD
Background: In populations affected by HIV/AIDS, women and those with SUD report worse HRQOL than men. To our knowledge, HRQOL sex differences have not been reported in HIV/AIDS and SUD-affected populations. Our objective was to investigate if sex differences in HRQOL exist in men and women affected by HIV/AIDS who also self-administer heroin and/or cocaine.

Methods: Men and women infected or not-infected with HIV, ages > 18 years, were recruited according to these categories: (1) no SUD, (2) heavy use of heroin and/or cocaine (> 3 times/week over the past 6 months), or (3) methadone treatment without concomitant heroin and/or cocaine use. Participants completed the Short Form-36 Health Survey, a measure of HRQOL.

Results: We recruited 258 individuals (52.7% male, 90% African-American, ages: non-users: 43.11 (8.70); heavy users: 41.30 (6.92); methadone maintenance: 44.70 (6.78)) who were primarily low-income inner city constituents. Women reported a poorer HRQOL than men after adjusting for SUD, HIV status and age. Men's HRQOL was negatively associated with either HIV/AIDS or SUD. Men and women receiving methadone treatment for SUD reported similar HRQOL as individuals who did not use drugs.

Conclusions: Women are particularly vulnerable in communities heavily affected by HIV/AIDS and SUD for experiencing decreased quality of life, regardless of their own HIV/AIDS/SUD status. Men with SUD had a poor HRQOL compared to non-users. Methadone treatment appears to ameliorate the adverse influence of heroin/cocaine use on HRQOL. In conclusion, of all factors analyzed HIV-infection, SUD and sex (female) were the greatest predictors of low HRQOL.

Learning Areas:
Provision of health care to the public
Public health or related nursing
Public health or related public policy
Public health or related research

Learning Objectives:
Compare experienced Health-Related Quality of Life by both HIV positive and HIV negative males and females in an inner city environment Identify experienced Health-Related Quality of Life differences for both HIV positive and HIV males and females with substance abuse disorders (SUD) Describe unique Health-Related Quality of Life difficulties for women in communities heavily affected by HIV/AIDS and Substance Abuse Disorders (SUD)

Keywords: HIV/AIDS, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with the research group on this project, and am a student at the School of Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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