Quality of life among women living with HIV: the importance violence, social support, and self care behaviors

This paper describes the relationship between psychosocial factors and heal th related quality of life among 287 HIV-positive women using items from th e Medical Outcomes Study HIV Health Survey to measure physical functioning, mental health and overall quality of life. Multivariate models tested the relative importance of sociodemographic characteristics, HIV-related factor s and psychosocial variables in explaining these quality of life outcomes. A history of child sexual abuse and adult abuse, social support and health promoting self-care behaviors were the psychosocial factors studied. Women in the sample were on average 33 years old and had known they were HI V-positive for 41 months; 39% had been hospitalized at least once due to th eir HIV; 83% had children; 19% had a main sex partner who was also HIV-posi tive. More than one-half of the women (55%) had a history of injection drug use and 63% reported having been physically or sexually assaulted at least once as an adult. A history of childhood sexual abuse, reported by 41% of the sample, was significantly related to mental health after controlling fo r sociodemographic and HIV-related characteristics. Women with larger socia l support networks reported better mental health and overall quality of lif e. Women who practiced more self-care behaviors (healthy diet and vitamins, adequate sleep and exercise, and stress management) reported better physic al and mental health and overall quality of life. The high prevalence of physical abuse and child sexual abuse reported by th is sample underscores the importance of screening for domestic violence whe n providing services to HIV-positive women. That such potentially modifiabl e factors as social support and self care behaviors are strongly associated with health-related quality of life suggests a new opportunity to improve the lives of women living with HIV. (C) 2000 Elsevier Science Ltd. All righ ts reserved.