Quality of life assessment among HIV-positive persons entering the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial

Ar Lifson, Ga Grandits, Em Gardner, Mj Wolff, P. Pulik, I. Williams, Wj Burman, International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objectives: With HIV treatment prolonging survival and HIV infection now managed as a chronic illness, quality of life (QOL) is important to evaluate in persons living with HIV (PLWH). We assessed at study entry the QOL of antiretroviral-naïve PLWH with CD4 counts >500 cells/μL in the Strategic Timing of AntiRetroviral Treatment (START) clinical trial. Methods: QOL was assessed with: (1) a visual analogue scale (VAS) for self-assessment of overall current health; (2) the Short-Form 12-Item Version 2 Health Survey® (SF-12V2), for which responses are summarized into eight individual QOL domains plus component summary scores for physical health [the Physical Health Component Summary (PCS)] and mental health [the Mental Health Component Summary (MCS)]. The VAS and eight domain scores were scaled from 0 to 100. Mean QOL measures were calculated overall and by demographic, clinical and behavioural factors. Results: A total of 4631 participants completed the VAS and 4119 the SF-12. The mean VAS score (with standard deviation) was 80.9±15.7. Mean SF-12 domain scores were lowest for vitality (66.3±26.4) and mental health (68.6±21.4), and highest for physical functioning (89.3±23.0) and bodily pain (88.0±21.4). Using multiple linear regression, PCS scores were lower (P<0.001) for Asians, North Americans, female participants, older participants, and those with less education, longer duration of known HIV infection, alcoholism/substance dependence and body mass index ≥30kg/m2. MCS scores were highest (P<0.001) for Africans, South Americans and older participants, and lowest for female participants, current smokers and those with alcoholism/substance dependence. Conclusions: In this primarily healthy population, QOL was mostly favourable, emphasizing that it is important that HIV treatments do not negatively impact QOL. Self-assessed physical health summary scores were higher than mental health scores. Factors such as older age and geographical region had different effects on perceived physical and mental health.

Original languageEnglish (US)
Pages (from-to)88-96
Number of pages9
JournalHIV Medicine
Issue numberS1
StatePublished - Apr 1 2015


  • Antiretroviral therapy
  • HIV
  • Quality of life

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