Symptoms are highly prevalent among HIV outpatients and associated with poor adherence and unprotected sexual intercourse
Résumé
Objectives There is a paucity of data reporting the prevalence and burden of pain and symptoms in the era of antiretroviral therapy. This study aimed to measure symptom prevalence and determine associations with key variables: demographics, treatment status, adherence and risk behaviours. Design Cross-sectional self-completion questionnaire in five outpatient clinics in London and South East of the UK. Methods Consecutive patients were invited to participate, responding to clinical and behavioural variables including the Memorial Symptom Assessment Schedule (Short-form). Four multivariable models examined the relationship between dependent variables of 1) psychological, 2) physical, 3) global symptom burden, 4) number of symptoms and key independent variables. 778 patients participated, response rate 77% of all patients approached. Results Both physical and psychological symptoms were highly prevalent: in the previous seven days, 70.8% experienced lack of energy, 69.9% worry, 53.6% diarrhoea, 53.5% sexual dysfunction, and 53.2% pain. In multivariable analysis, psychological distress was significantly and independently associated with both unprotected sexual intercourse with a partner of unknown status, and with poorer ART treatment adherence. Lower educational achievement was significantly associated with increasing physical, psychological and global symptom burden, and with higher number of symptoms. Being on treatment was not associated with any symptom distress measure. Conclusions In the era of treatment, patients continue to experience high prevalence and burden of psychological and physical symptoms, which are not associated with treatment status. Attention to these distressing problems is essential to enhance quality of life, enhance adherence and minimise risk behaviour.
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