Health-related quality of life in asymptomatic patients with HIV - Evaluation of the SF-36 health survey in Italian patients

Objective: Tn investigate the psychometric performance and clinical validit y of the 36-Item Short Form (SF-36) health survey when completed by asympto matic HIV-positive Italian patients and to compare their health profile wit h a representative sample of 2031 Italian citizens (the Italian norm). Patients and Methods: This was an observational, multicentre, cross-section al survey. Microbiologists throughout Italy recruited asymptomatic HIV-posi tive individuals who were aged at least 18 years and aware of their infecti on. Investigators collected demographic, social, clinical and treatment dat a. Patients, classified into 2 clinical categories (A1 and A2) according to explicit pre-defined criteria, completed the SF-36 health survey in the co ntext of a medical visit. Results: Between April and July 1996, 46 microbiologists recruited 214 pati ents (201 evaluable). No inconsistent responses were observed in 96% of the sample. The usually recommended psychometric standards were satisfied, and the internal consistency reliability indices were always greater than 0.70 . Weak to moderate associations were found between SF-36 health survey scor es and physicians' estimates of patients' physical performance, while no si gnificant associations were found with CD4+ counts. On average, HIV-positiv e patients reported lower scores than the Italian norm, and patients in cat egory A2 showed lower scores than patients in Al. These differences were mo re relevant in scales describing role limitations, general health perceptio n, and psychological well-being. Conclusion: Our study showed that the SF-36 health survey maintained its ps ychometric properties in a sample of Italian asymptomatic HIV-positive pati ents and produced data that showed its validity and robustness in such a se tting.