The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors

Tracy L. Gard, Donald R. Hoover, Qiuhu Shi, Mardge H. Cohen, Eugene Mutimura, Adebola A. Adedimeji, Kathryn Anastos

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose: We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. Methods: The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics. Results: Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. Conclusions: This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.

Original languageEnglish (US)
Pages (from-to)2073-2084
Number of pages12
JournalQuality of Life Research
Volume22
Issue number8
DOIs
StatePublished - Oct 1 2013

Keywords

  • HIV
  • Post-traumatic stress disorder
  • Quality of life
  • Rwanda
  • Women

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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