Prevalence, severity, and risk factors of disability among adults living with HIV accessing routine outpatient HIV care in London, United Kingdom (UK): A cross-sectional self-report study.

Autor: Brown DA; Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom., O'Brien KK; Department of Physical Therapy, University of Toronto, Toronto, Canada.; Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Canada.; Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Canada., Harding R; Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.; Cicely Saunders Institute of Palliative Care, Policy and Rehabilitating, King's College London, London, United Kingdom., Sedgwick PM; Institute of Medical and Biomedical Education, St George's, University of London, London, United Kingdom., Nelson M; Department of HIV Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom.; Faculty of Medicine, Department of Medicine, Imperial College London, London, United Kingdom., Boffito M; Department of HIV Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom., Lewko A; Centre for Allied Health, Kingston University and St George's University of London, London, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 May 12; Vol. 17 (5), pp. e0267271. Date of Electronic Publication: 2022 May 12 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0267271
Abstrakt: Background: The study objectives were to measure disability prevalence and severity, and examine disability risk factors, among adults living with HIV in London, United Kingdom (UK).
Methods: Self-reported questionnaires were administered: World Health Organization Disability Assessment Schedule 2.0 (WHODAS), HIV Disability Questionnaire (HDQ), Equality Act disability definition (EADD), and demographic questionnaire. We calculated proportion (95% Confidence Interval; CI) of "severe" and "moderate" disability measured using EADD and WHODAS scores ≥2 respectively. We measured disability severity with HDQ domain severity scores. We used demographic questionnaire responses to assess risk factors of "severe" and "moderate" disability using logistic regression analysis, and HDQ severity domain scores using linear regression analysis.
Results: Of 201 participants, 176 (87.6%) identified as men, median age 47 years, and 194 (96.5%) virologically suppressed. Severe disability prevalence was 39.5% (n = 79/201), 95% CI [32.5%, 46.4%]. Moderate disability prevalence was 70.5% (n = 141/200), 95% CI [64.2%, 76.8%]. Uncertainty was the most severe HDQ disability domain. Late HIV diagnosis was a risk factor for severe disability [Odds Ratio (OR) 2.71; CI 1.25, 5.87]. Social determinants of health, economic inactivity [OR 2.79; CI 1.08, 7.21] and receiving benefits [OR 2.87; CI 1.05, 7.83], were risk factors for "severe" disability. Economic inactivity [OR 3.14; CI 1.00, 9.98] was a risk factor for "moderate" disability. Economic inactivity, receiving benefits, and having no fixed abode were risk factors (P≤0.05) for higher HDQ severity scores in physical, mental and emotional, difficulty with day-to-day activities, and challenges to social participation domains. Personal factors, identifying as a woman and being aged <50 years, were risk factors (P≤0.05) for higher HDQ severity scores in mental and emotional, uncertainty, and challenges with social participation domains.
Conclusions: People living with well-controlled HIV in London UK experienced multi-dimensional and episodic disability. Results help to better understand the prevalence, severity, and risk factors of disability experienced by adults living with HIV, identify areas to target interventions, and optimise health and functioning.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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