Quality of life among older Chinese people living with HIV/AIDS: a cross-sectional study in Hunan.

BACKGROUND: There is little research to date in the area of quality of life (QoL) among older Chinese people living with HIV/AIDS (PLWHA). This study aims to explore the QoL and its influential factors among older PLWHA in China. METHODS: Cross-sectional data of 242 adults with HIV/AIDS aged 50-84 y from Hunan were analyzed to evaluate the associations of demographic characteristics, illness-related factors, HIV-related stigma and social support with QoL. The WHO QOL-HIV BREF questionnaire was used to measure QoL on six domains (physical, psychological, independence, social relationships, environment and spirituality). RESULTS: A total of 242 older PLWHA completed the survey, of whom 150 (62.0%) were males. Multivariate linear regression analyses identified that females, side effects of highly active antiretroviral therapy, chronic non-communicable diseases and higher levels of perceived negative self-image were negatively associated with QoL, especially in the physical, independence and spirituality domains; whereas higher education or annual income, retired and elevated levels of subjective social support or support availability were positively associated with QoL, especially in the psychological, independence, social relationships and environment domains. CONCLUSIONS: The study findings suggest that interventions to improve QoL should focus on reducing HIV-related stigma and side effects and on enhancing economic situations and social support.

Association of COMT Gene Polymorphisms with Response to Methadone Maintenance Treatment Among Chinese Opioid-Dependent Patients.

Aim: To explore the association of the COMT gene polymorphisms (rs4680, rs737866, and rs933271) with the response to methadone maintenance treatment (MMT) among Chinese opioid-dependent patients. Methods: A total of 820 patients who were receiving MMT from Chinese clinics were recruited. Questionnaires were used to collect patient information, including sociodemographics, history of drug use, and stable methadone dosages. Three polymorphisms of COMT, rs4680, rs737866, and rs933271, were selected and genotyped using the Sequenom MassARRAY platform. Results: After adjusting for related factors including age, marital status, and methadone dosage, the genotype TC at rs933271 was demonstrated as the dominant difference between the MMT responsive group and nonresponsive group (p = 0.02, odds ratios [OR]: 1.57). In the dominant model of inheritance, the individuals carrying the TC or CC genotypes at rs933271 were more likely to respond to MMT than patients with the genotype TT (p = 0.02, OR: 1.53). No significant associations were observed between any of the allelic or genotypic variants of the rs4680 and rs737866 loci, and the response to MMT in this Chinese population. Patients with the haplotype A-T-A (rs737866-rs933271-rs4680) were more frequent in the nonresponsive group than in the responsive group (p < 0.05). Conclusion: COMT genetic variability is associated with the response to MMT.

Coping strategies and associated factors among older Chinese people living with HIV/AIDS.

Coping strategies play a prominent role in maintaining mental health, but little is known about the main coping strategies and potential influential factors among older Chinese adults with HIV/AIDS. Cross-sectional data of 254 older with HIV/AIDS aged 50 ~ 84 years (160 males and 94 females) from Hunan, China were analyzed to evaluate influential factors associated with coping strategies. The scores of all participants in the different sub-scales of confrontation, avoidance and acceptance-resignation were 15.16 ± 4.03, 16.44 ± 2.70, and 11.06 ± 4.00, respectively. For the confrontation coping strategy, higher scores were obtained by those with a higher education level, non-sexually transmitted HIV, and a first diagnosis at less than 50 years old. Avoidance as a coping strategy was significantly associated with a longer period living with the diagnosis. The participants who were females, unemployed, annual income less than 1000 yuan, had lived with HIV for a longer period, and had disclosed their infection status to their family members were more likely to adopt the acceptance-resignation coping strategy in response to HIV/AIDS. These preliminary findings can provide evidence for effective interventions to improve coping capacity and psychological status in this population.

Older people living with human immunodeficiency virus/acquired immune deficiency syndrome in Chinese rural areas: perceived stigma and associated factors.

BACKGROUND: Perceived stigma is a common problem among people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA). In recent years, the number of older adults with HIV/AIDS has rapidly increased in China. However, HIV/AIDS-related perceived stigma and associated factors in older PLWHA remain unknown. METHODS: A cross-sectional study was conducted in Yongzhou. Participants were recruited via the Hunan HIV/AIDS Registry system. All participants were ≥50 y of age at the time of their HIV diagnosis. Sowell's HIV Stigma Scale was used to measure perceived stigma. RESULTS: A total of 193 participants were interviewed, of which 132 (68.4%) were male. The ages of the participants ranged from 50 to 82 y and the average age was 61.1±5.95 y. Eighteen (9.3%) subjects were ethnic minorities. Older PLWHA reported a relatively high level of perceived stigma, especially individuals of Han ethnicity having high annual incomes. The individuals who had disclosed their HIV-positive status to all their family had higher scores on the dimension related to blame. Regression analysis showed that ethnicity, annual income, living arrangement and disclosure patterns were the main associated factors of perceived stigma. CONCLUSIONS: Perceived stigma is common in older Chinese PLWHA. Individuals of ethnic minorities or with higher economic status have higher levels of stigma. Family relationships have a deep influence on perceived stigma.