Quality of life in patients with human immunodeficiency virus infection: impact of social support, coping style and hopelessness

We aimed to determine whether the quality of life (QOL) in the patients inf ected with human immunodeficiency virus (HIV) infection was influenced by s atisfaction with social support, coping style and hopelessness. One hundred and thirty-eight HIV-infected patients were prospectively studi ed in this multicentre, longitudinal study. The QOL was assessed by Medical Outcome Study Health Survey SF-36, social support by Sarason Social Suppor t Questionnaire, hopelessness by Beck Hopelessness Scale, and coping by Bil ling and Moos Inventory of coping with illness. The QOL did not correlate with age, sex, race, HIV risk factor, education o r marital status. Employment (P=0.0001), higher income (P=0.03), satisfacti on with social support (P=0.04), regardless of the source of that support, and problem-focused coping (P=0.03) were associated with a significantly be tter QOL, while, emotion-focused coping (r=-0.19, P=0.04), avoidant coping (r=0.40, P=0.0001), hopelessness (r=-0.64, P=0.0001) and AIDS (P=0.09) were predictors of poorer QOL. Physical functioning correlated positively with employment (P=0.0001), and inversely with AIDS (P=0.0002), hopelessness (P= 0.03), avoidant coping (P=0.03), and age (P=0.10). At 6 months follow up, Q OL score had changed in 20% of the patients; older age (P=0.01), and lesser satisfaction with social support (P=0.15) were associated with a decline i n QOL, while adherence with antiretroviral therapy (P=0.006) was associated with an increase in QOL score. Seven of 138 patients died during follow up ; these patients had significantly lower QOL at baseline than all other pat ients (P=0.003). Interventions to alleviate hopelessness, maladaptive coping, and enhancemen t of satisfaction with social support may improve overall QOL in HIV-infect ed patients. Older patients with HIV were less satisfied with their social support, were more likely to utilize unhealthy coping styles, and experienc ed a greater decline in QOL over time.