Measuring health status and quality of life in HIV and AIDS

Abstract

HIV can diminish quality of life profoundly, and it is important to understand and measure such effects of HIV and its treatments Although the term quality of life is commonly used, “health status” more accurately describes dimensions that are directly health related and that may be affected by traditional interventions. There is a substantial literature on general health status measurement, and several of the most established measures have been applied or adapted for use in HIV infected populations These measures include the Medical Outcomes Study health ratings, the Quality of Well-Being scale, and the Sickness Impact Profile. Cancer-specific measures such as the EORTC Quality of Life Core Questionnaire and the CARES have also been adapted. In the last three years, health status measures for HIV have been completed by several thousand patients, and have generally proved to be reliable and valid indicators of relevant clinical differences such as disease stage, numbers of symptoms, and other psychometic measures of disability and distress. Health status measures were included in a few completed clinical trials, and are being incorporated in a growing number of antiretroviral and antimicrobial studies. Health status measures provide the best way to evaluate psychosocial interventions directly aimed at improving patients' quality of life. Although challenges remain in further developing health status measures for HIV disease and in applying them, measurement of these concepts has proved to be both technically and operationally feasible. Measures of health status and quality of life can play an important role in the evaluation of clinical treatments in research studies, directing clinical treatment, assessing changes in health care delivery, and planning health care services.