| Background. Health-related quality of life is highlighted as a key element in the overall health of persons diagnosed with HIV/AIDS. Despite advances in antiretroviral treatments, persons diagnosed with HIV are faced with socioeconomic, healthcare and treatment-related challenges which they must incorporate into their daily lives. Women diagnosed with HIV are especially vulnerable as they are disproportionately low income and face limited access to care (Shapiro et al. 1999). A high prevalence of complementary and alternative medicine use (CAM) is reported among HIV-infected populations. While the effectiveness of many CAM therapies is not yet proven, patients expect that these therapies will improve their quality of life (Sparber et al. 2000).;Methods. The purpose of this study is to examine the correlates and predictors of health-related quality of life and the use of CAM therapies among women diagnosed with HIV. A cross sectional analysis was conducted using secondary data from the Women's Interagency HIV Study (WIHS) collected in September 2003. Using the constructs of the socio-behavioral model to organize the sequence of predictors, a sequential logistic regression and a hierarchical multiple regression model were constructed to fit the data. CAM users were defined as women who reported using as least one CAM therapy at the study baseline. Health-related quality of life was operationalized using three measures, physical health, mental health and reported symptoms.;Results. The study sample consisted of a total of 1,470 non-Hispanic Blacks, non-Hispanic Whites and Hispanic women diagnosed with HIV. Six hundred women (41%) reported using at least one CAM therapy and 870 (59%) reported not using any CAM. The findings suggest that a conceptual framework based on the socio-behavioral model is useful to the study CAM use and health-related quality of life. The highest odds of CAM use were predisposing factors, i.e. race/ethnicity (odds ratio [OR] = 3.5, confidence interval [95% CI]: 2.43-5.25), education (OR=.776, 95% CI: .610-.987) and perception of disease severity (OR=1.067, 95% CI: 1.01-1.12). Enabling factors, employment (beta coefficient [beta]= .171) and health-related service use (beta= -.221) were the strongest predictors of physical health; mental health (beta= .117, and beta= -.159, respectively) and reported symptoms (beta= -.117, and beta= .210, respectively). CAM users reported higher perceptions of disease severity i.e. they were less likely to perceive HIV as controllable and were less optimistic about the future outlook of the disease. The use of CAM therapies predicted lower physical health and more reported symptoms suggesting that CAM use was less effective among women with higher perceptions of disease severity.;Conclusion. With recent shifts in the pattern of the HIV/AIDS epidemic, recognizing and addressing the socioeconomic, healthcare and treatment-related needs of a growing population of HIV positive women are important public health goals. Furthermore, it is important that healthcare providers understand patient's perceptions of their disease as these can have important implications for their use of self-care strategies (such as CAM therapies) and their prospects for improved quality of life while living with HIV. |
