| Background and Objective:Nowadays,the proportion of elderly people living with HIV(the age of ?50 years)was increasing year by year in China.With the advent of antiretroviral therapy for more than 20 years,and the widespread treatment of antiretroviral drugs,the mortality of people infected by HIV had significantly reduced,their life expectancy was more and more close to that of general people,and the burden of the elderly people living with HIV was gradually increasing.In addition,AIDS had given rise to more and more psychological and social problems.In addition to the physical damage from the disease itself,the psychological problems were caused by the stigma and lack of social support resulted in the lack of social integration problems.These had a negative impact on the quality of life of the people living with HIV/AIDS.The cross sectional study was conducted to analyze basic characteristics,circumstances of quality of life and the factors influencing their quality of life among the elderly male people living with HIV/AIDS in Wuxi.And as the general male community residents were the control group,the case-control study was carried out to analyze influencing factors of elderly people with HIV,and then quality of life between the two groups for understanding its influences through stratifying age,economic conditions and others.The aim of the study was to improve the quality of life of elderly men with HIV/AIDS,and provide references and suggestions for lowing down speed of HIV propagation and decreasing HIV mortality.Methods:1.Cross sectional study:the elderly men with HIV/AIDS living in eight counties in Wuxi were recruited by convenient sampling method from February 2016 to December.The contents of the survey were:general demographic characteristics,36-item short-form health survey,AIDS-related knowledge questions and questions of psychological change,and contents of sexual health and behaviors.2.Case-control study:cases were from the objects of the cross sectional study.objects of control group were the male residents(age 50 ? years)in Xishan District in Wuxi.The matching factor was age,and the match ratio was 1:2.The contents of the survey were the same as those of cross sectional study.3.Statistical method:data was recorded using Epi Data 3.1 software and analyzed by SPSS 19.0 and SAS 9.2 software.In the continuous data,the normality test was carried out,firstly.If the two groups were normal distribution and the variance was equal,the t test was used to compare the groups,and the variance analysis was performed in multiple groups,if variance was not equal,the Satterthwaite approximation method was performed.If data was not normal distribution,the two groups were analyzed by the nonparametric Mann-Whitney rank sum Test,and multiple groups were performed by Kruskal-Wallis rank sum test.In the continuous data,the x2 test was perfomed,if the theoretical value was<1,Fisher exact probability test was performed.Cronbach's a coefficient and sub-half reliability were used to measure the reliability of the scale,and the confirmatory factor analysis was performed to measure its contract validity.The above test level was 0.05.The multiple linear regression analysis was performed where the stepwise regression method was used.The conditional logistic regression analysis was performed where stepwise back method was used.The inclusion level was 0.10 and the exclusion level was 0.15.Results:1.There were 194 elderly male people living with HIV/AIDS investigated in cross sectional study in Wuxi,where 113(59.6%)patients were infected by heterosexual transmission,77(38.3%)were by homosexual transmission,and 89(45.8%)patients suffered from chronic diseases.To understand the circumstances of AIDS-related knowledge,the awareness rates of 7/8 core knowledge points were close to or higher than 70%.36(22.4%)patients had sexual health inquiry experience,30(18.6%)had contraception guidance experience,55(34.2%)had health education of sexual transmitted diseases prevention.32(16.5%)patients had sexual transmitted diseases in the past.There were 151(77.8%)patients having the history of commercial sexual behavior,and 34(17.5%)had sexual life in the last 1 year.2.193 elderly male patients with HIV/AIDS in Wuxi were investigated by SF-36,and the coefficient of Cronbach's a and the half confidence were all higher than 0.7.The confirmatory factor analysis showed the two factors were correlated with its theoretical hypothesis.Its reliability and validity were good.The scores of 8 dimensions in SF-36 were lower than the male population in Shanghai,and higher than those of the Chinese people infected with HIV.The multiple linear regression analysis showed family per capita monthly income and annual medical expenditure influenced on scores of PF RP GH RE and weighted average score.Furthermore,influencing factors of different dimensions of SF-36 also had other factors,such as smoking,drinking,age,ones suffering from chronic diseases and so on.3.To analyze the single factor of the elderly male patients with HIV/AIDS,we found that,marriage,type of medical insurance,family per capita monthly income,drinking,parenting experience,chronic disease,whether suffering from sexual transmitted diseases in the past and the history of commercial sexual behavior had statistical significance.The analysis of conditional logistic regression showed the risk factors:having sexual transmitted diseases in the past(OR = 5.37,95%CI(2.12,13.59)),and having the history of commercial sexual behavior(OR=2.53,95%CI(1.25,5.11)).The unstable marriage was associated with HIV infection(OR=9.51,95%CI(5.00,18.09)).4.The analysis of quality of life of general elderly male people also had good reliability and validity.To compare scores of every dimension of SF-36 in the case and control group,we found:Stratified by age,scores of GH RP VT SF and MH dimensions in SF-36 of case group were lower than those of control group,the difference was statistically significant;stratified by the family per capita monthly income,scores of VT GH SF and MH dimensions of case group were lower than those of control group,the difference was statistically significant;stratified by marital status,scores of GH VT SF and MH dimensions of case group were lower than those of control group,the difference was statistically significant;stratified by the history of commercial sexual behavior,scores of RP GH VT SF and MH dimensions of case group were lower than those of control group,the difference was statistically significant.Conclusion:1.The proportion of patients infected through heterosexual transmission among elderly male patients with HIV/AIDS in Wuxi was high.The rate of patients suffering from chronic diseases was high.And the negative emotions of the elderly male patients with HIV/AIDS were related to the time of HIV infection,and there was a abvious downward trend.The elderly male patients with HIV/AIDS had less sexual health service,high incidence of high risk sexual behavior,and low frequency of sexual life.2.The circumstances of quality of life of case group were superior to those of patients with HIV infection in China,but was lower than those of the general population.The main influencing factors of the quality of life were family per capita monthly income,annual medical expenditure,drinking,smoking and chronic diseases.3.The risk factors of the elderly male patients infected by HIV/AIDS in Wuxi were history of other sexual transmitted diseases,and experience of commercial sexual behavior.The unstable marriage was associated with HIV infection.4.The analysis of quality of life of objects of case and control groups had good reliability and validity.The stratified analysis of the two groups revealed that,as the age increased,the impact of HIV infection on quality of life was reduced,and the quality of life of elderly male patients with HIV/AIDS in the lower age group was poorer.The mental components of quality of life of elderly male patients with HIV/AIDS who were the low family per capita monthly income,or stable marriage or no experience of commercial sexual behavior were poorer,and the physical and mental components of quality of life of those experiencing commercial sexual behavior were poorer. |
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