Psychological distress and quality of life in drug-using and non-drug-using HIV-infected women

Abstract

Background: Quantitative research on women infected with human immunodeficiency virus (HIV) has predominantly involved drug users. The present study assessed the psychosocial burden of HIV infection and identified some possible determinants in both drug-using and non-drug-using women. Method: Twenty-three hard-drug-using and 55 non-using HIV-positive women aged 18-64 years participated. Psychological distress (SCL-90, with eight scales and total score) and health-related quality of life (Rand SF-36, with eight scales and physical and psychosocial dimension) were measured. A cross-sectional comparison with reference groups (female general population, female psychiatric patients and HIV-positive homosexual men) was made. For analysis the t-test and multiple regression analysis were used. Results: Compared to the general population, both HIV-positive groups had higher (i.e. unfavourable) SCL total scores (t=8.33 and p<0.001 and t=4.97 and p<0.001) and lower (i.e. unfavourable) Rand SF-36 scores (p<0.001 on seven or more scales). Compared to psychiatric patients, drug users had similar (n.s.) and non-drug users had lower (t= -9.09 and p<0.001) SCL scores. Both groups had lower SF-36 scores (p<0.001 on seven or more scales). Compared to HIV-positive homosexuals, drug users had higher (t=2.88 and p<0.01) and non-drug users had similar SCL scores (n.s.). Psychosocial illness burden (SCL and Rand psychosocial dimension) was associated with low self-esteem, poverty, ethnic minority membership and illness stage (Rand only). Child care, drug use/prostitution and illness stage predicted high physical illness burden. Conclusion: Women with HIV/AIDS (acquired immune deficiency syndrome) experience considerable distress and poor quality of life, but drug users do more so than non-users. Drug- and gender-related lifestyles affect illness burden.