Quality of Life in HIV-Infected Patients in Penitentiary Institutions

Abstract

Background. Prisoners have a lower quality of life compared to the general population. The decline in their quality of life may be due to unfavorable social and demographic factors, as well as a number of physical and mental health problems, in particular human immunodeficiency virus. Purpose of the work. The purpose of this study was to assess the quality of life of infected persons with human immunodeficiency virus in penitentiary institutions of Azerbaijan and their relationship with various indicators. Material and methods. The study was conducted in penitentiary institutions of Azerbaijan among prisoners meeting the inclusion criteria, a cross-sectional design was used. The study was approved by the Ethics Committee of the Azerbaijan Medical University (P.23/19.05.2022). Demographic and clinical data including age, gender, course of human immunodeficiency virus infection, antiretroviral therapy, drug use and length of incarceration were collected using a structured questionnaire. Standardized assessment methods were used, including the Hospital Anxiety and Depression Scale and the Mini Mental Test to assess neurocognitive performance. The quality of life of patients was assessed using the SF 36 questionnaire.The obtained quantitative and qualitative data were statistically processed using medical statistics methods. Results. The average score for the “physical health” domain of quality of life was 55.2 points, and the average score for the “mental health” domain was 52.8. Subjects with HIV-associated dementia had the lowest quality of life scores in the categories of “physical functioning” (p=0.05), “mental health” (p<0.001), “body pain” (p<0.001), “vitality” (p=0.001) and “general health” (p=0.001) compared with those with asymptomatic and mild neurocognitive disorders. The lowest scores in all areas of quality of life were observed in patients with severe depression and severe anxiety (p<0.001). At the same time, the subjects who were not diagnosed with either anxiety or depressive disorders showed the highest scores when assessing quality of life (p<0.001). Conclusion. Low quality of life was associated with the presence of varying degrees of depression, anxiety disorders, and cognitive impairment (p<0.001). At the same time, the age of the patients, gender, education, years of imprisonment, antiretroviral therapy did not affect the quality of life. The results of this study will help assess the overall quality of life of human immunodeficiency virus positive prisoners, identifying possible connections with various aspects of the disease itself and its neurological complications.