Stress at Time of HIV Diagnosis May Affect Later Psychosocial Status

As HIV infection becomes a chronic illness, assessing psychosocial status regularly and implementing effective interventions aimed at related problems as they arise may be particularly important for people living with HIV (PLWH) to improve their health-related quality of life (HRQOL), according to a new study.

Stress levels at the time of diagnosis, along with changes in stress and depression status within 1 year, could prospectively influence the HRQOL 1 year after diagnosis among newly diagnosed PLWH, researchers said.

In this study, a consecutive sample of newly diagnosed PLWH was recruited from Changsha Center for Disease Control and Prevention in Hunan Province, China. A total of 410 participants completed both the baseline and 1-year follow-up surveys. Measures used included the Medical Outcomes Study HIV Survey, the 9-item Patient Health Questionnaire, the HIV/AIDS Stress Scale, and the Social Support Rating Scale.

Higher stress levels at baseline predicted a lower HRQOL at 1 year, while baseline depression status and social support did not predict 1-year HRQOL scores. Compared with those who were never depressed at both baseline and follow-up, participants who experienced new-onset or persistent depression had lower HRQOL at 1 year.

Additionally, the 1-year HRQOL score of participants who recovered from depression by follow-up was comparable to that of participants who were never depressed. Moreover, participants who experienced increases in stress levels by follow-up had lower HRQOL scores at 1 year than those with decreases in stress levels. Changes in social support did not predict 1-year HRQOL scores in this study.

The initial diagnosis may be upsetting for many since they have to face a future life with HIV infection, and struggle with multiple HIV-specific stressors such as disclosure, psychological adjustment, and making treatment decisions.

When working with PLWH, particular attention should be given to those with new-onset or persistent depression and those with high stress levels at the time of diagnosis and increased stress levels 1 year after the new HIV diagnosis, the researchers said. Future studies should focus on the intersection of psychosocial status and HRQOL rather than only a 1-time assessment; this population's HRQOL would benefit from regular psychosocial status assessment, allowing for interventions.

Reference

Huang Y, Luo D, Chen X. Role of psychosocial status in predicting health-related quality of life at 1-year follow-up among newly diagnosed people living with HIV [published online October 23, 2019]. PLoS One. doi.org: 10.1371/journal.pone.0224322.