Study On Living Situation Of People Living With HIV/AIDS In Suizhou City Of Hubei Province

PurposeThis study examined various characteristics of former paid plasma donors from Suizhou City in Hubei Province. The purpose of this research was to describe: 1) the demographic characteristics of PLWHA in Suizhou City; 2) their knowledge of HIV transmission and prevention, 3) their perception of the presence of stigma and discrimination, 4) existence of depression among the PLWHA in the study group and identification of the risk factors for depression, and 5) the quality of life of the PLWHA in the study group and identification of factors affecting quality of life. By describing the basic living situation and quality of life indicators we can develop possible interventions for the care and treatment of HIV infected former paid plasma donors in rural central China.MethodThis study analyzed HIV infected former paid plasma donors from Suizhou City, Hubei Province. Samples were chosen by using directional sampling method, Individual questionnaires were used to obtain the information. The questionnaire included: social characteristics; HIV-related information of the PLWHA and their family members; Dates and frequency of plasma donation; CES-D scale; Symptom scale and WHOQOL-HIV-BREF. All questionnaires were finalized after piloting and modifying. Interview results were entered into a database using SPSS and analysisperformed using SPSS and Excel. The main methods were: describing method; statistic test; correlation analysis and multivariable linear analysis.Results1. Most of the patients were middle aged, low social class, and living on a farm. 25.64 reported no annual income and the median annual income of the remaining study participants was only 667 RMB. 69.87 percent of the study participants reported symptoms of HIV/AIDS requiring treatment. 148 PLWHA were receiving treatment. 36 patients had HIV infected family members which increased the burden of disease and difficult to support each other.2. The overall knowledge of HIV/AIDS was 84.62%. Although 90% answered the questions about how HIV is not transmitted correctly, only about 20% knew that HIV could be transmitted through sharing needles or syringes, shavers, toothbrushes and breastfeeding. 73.08% knew that condoms could prevent HIV transmission.3. Sexual behavior is one of the most risky behaviors for HIV transmission among PLWHA. Our study found that 7 patients were most likely infected with HIV by their HIV infected sexual partner. Many PLWHA will continue to be sexually active but without adequate knowledge about HIV transmission and prevention using condoms. more HIV infections may occur.4. The depression rate of the study group of PLWHA was 77.56%. Most were poor, rural residents who lacked social support and experienced heavy HIV stigma and discrimination. Multivariate linear regression analysis found that the presence of physical symptoms and perceived HIV stigma were causative factors of depression while higher quality of life prevented depression. It could explain 61.3 percent of depression variances. Also, being female, widowed and a self diagnosis of AIDS were more likely to be depressed.5. Linear correlation analysis was done comparing the WHOQOL-HIV-BREF and WHOQOL-BRFE. The correlation coefficient of total score of QOL was 0.943 and for physical and social relationship areas were approximately 0.9, while thespirit/religion/self belief area had a middle correlation coefficient. Therefore WHOQOL-HIV-BREF can be used as a substitute for WHOQOL-BREF to evaluate the QOL of PLWHA.6. The average total QOL score was 76.69 ± 13.20.The total score and the score for physical, psychological and independence areas were all lower than the country average but spiritual/religious/self belief areas were all higher than country norms. Multivariate linear regression analysis found that total depression score and physical symptoms score negatively affected QOL while total evaluation of health and QOL had a positive relationship with QOL. It could explain 68.6 percent of QOL. Low income and a self diagnosis of AIDS were more likely to have a lower QOL.Conclusion and Suggestions1. The living situation of PLWHA of former blood donors isn't optimistic. The government and social department must pay more attention to them.2. Most of PLWHA are poor, lack knowledge about HIV, have a high rate of depression, experience HIV-related symptoms without adequate treatment, experience heavy stigma and discrimination, continue to practice high risk behaviors for HIV transmission, have low QOL and have many risk factors that could lead to worsening QOL and depression. Although ART can prolong the life of PLWHA, the living situation of PLWHA isn't optimistic. The government and social department must pay more attention and help them. Integrated HIV preventive and control measures should be done in order to build a stigma and discrimination free environment so that PLWHA can have self-respect, self-love and a high quality of life.3. PLWHA continue to practice high risk HIV transmission behaviors. Patient education must be strengthened in order to help PLWHA avoid transmission of HIV to others.The HIV knowledge of PLWHA was not as good as expected. High risk behavior was present and the potential for further HIV transmission is possible. Improving HIV education of those currently HIV infected and those undergoing HIV testing at VCTsites should be done. Risk reduction identification and education should be carried out with all HIV infected and non-infected persons.4. The depression of PLWHA was heavy and had many influencing factors. Medication, psychological counseling and depression prevention and early identification of depression should be available to all PLWHA. Interventions directed at the causative factors for depression should be explored including microfinance, home based care, and peer support groups.5. The QOL of PLWHA was significantly lower than the nation. Treating depression and providing effective symptom management can enhance overall QOL.6. Decreasing HIV-related stigma and discrimination and providing symptom management will relieve depression and improve overall QOL.HIV stigma and discrimination and the presence of HIV-related symptoms were the most important factors for both depression and QOL. Although it is difficult to decrease discrimination, knowledge about HIV is one step in lessening it. HIV education, mental health counseling and peer support also helps rebuild the confidence and self respect of PLWHA. HIV infected persons should expect the same quality treatment as someone who is not HIV infected. Actively managing symptoms can not only stop the progression of depression but can also enhance QOL through physical and psychological improvement. Teaching the PLWHA how to identify symptoms early and proper management can decrease depression and improve QOL.