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Improving Health-Related Quality of Life among People Living with HIV: Results from an Impact Evaluation of a Food Assistance Program in Uganda.

Maluccio JA, Palermo T, Kadiyala S, Rawat R - PLoS ONE (2015)

Bottom Line: We examined the impact of a food assistance intervention, previously shown to have reduced household food insecurity and improved nutritional status, on HRQoL of PLHIV.Over 12 months, food assistance significantly increased physical health scores (PHS) by 2.85 (P < .01) or approximately 0.35 SD, and reduced substantially the number of self- and healthcare provider-reported HIV-related symptoms by 3.83 and 2.68, respectively (P < .01).There was no significant impact, however, on mental health scores (MHS).

View Article: PubMed Central - PubMed

Affiliation: Department of Economics, Middlebury College, Middlebury, Vermont, United States of America.

ABSTRACT

Introduction: Widespread food insecurity in Africa continues to compromise an effective response to the AIDS epidemic. Health-related quality of life (HRQoL) is a comprehensive indicator of physical, mental, and social well-being that is associated with food insecurity and increasingly used to assess the well-being of people living with HIV/AIDS (PLHIV). We examined the impact of a food assistance intervention, previously shown to have reduced household food insecurity and improved nutritional status, on HRQoL of PLHIV.

Methods: We capitalized on an existing intervention targeting antiretroviral therapy (ART)- naïve PLHIV in Uganda, and conducted a prospective impact evaluation including a treatment and a comparison group. Data analyzed included 640 participants from two districts (318 in the intervention district) interviewed in both clinic and household settings at baseline and again approximately one year later. The main outcomes considered were physical and mental health dimensions of HRQoL, and other outcomes included self- and healthcare provider-reported symptoms. We utilized difference-in-difference propensity score matching methodologies to infer causality and examine program impacts.

Results: Over 12 months, food assistance significantly increased physical health scores (PHS) by 2.85 (P < .01) or approximately 0.35 SD, and reduced substantially the number of self- and healthcare provider-reported HIV-related symptoms by 3.83 and 2.68, respectively (P < .01). There was no significant impact, however, on mental health scores (MHS).

Conclusions: This study demonstrates the potential importance for HRQoL of including food assistance programming as part of the standard of care for PLHIV in areas of widespread food insecurity.

No MeSH data available.


Recruitment and Follow-up of Study Subjects.
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pone.0135879.g001: Recruitment and Follow-up of Study Subjects.

Mentions: The protocol (beginning with the individual survey administered at the clinic and then the household survey at the residence) was the same for the 12-month follow-up interview. Endpoints to the study, for which participants were not re-interviewed, included households in the comparison district that began receiving similar food assistance from another organization after recruitment or individuals in either district initiating ART before follow-up, since the primary outcomes studied in the intervention were nutritional status and CD4 count, both of which could be affected by these developments [14]. The number of individuals becoming eligible for ART after recruitment may have been increased by changes in the World Health Organization (WHO) recommendations for ART eligibility based on CD4 counts made in 2010 [44]. We re-interviewed as many of these individuals as possible prior to receipt of outside food assistance or initiation of ART. When such prior interview was not feasible, the individual was considered lost to follow-up (Fig 1). Therefore, we did not interview all participants a full 12 months after recruitment—77% of study subjects at follow-up were re-interviewed between 10–13 months after their baseline interview, 15% were interviewed before 10 months (mean 8.2; standard deviation [SD] 1.8) and 8% after 13 months (mean 14.6; SD 2.2).


Improving Health-Related Quality of Life among People Living with HIV: Results from an Impact Evaluation of a Food Assistance Program in Uganda.

Maluccio JA, Palermo T, Kadiyala S, Rawat R - PLoS ONE (2015)

Recruitment and Follow-up of Study Subjects.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4552093&req=5

pone.0135879.g001: Recruitment and Follow-up of Study Subjects.
Mentions: The protocol (beginning with the individual survey administered at the clinic and then the household survey at the residence) was the same for the 12-month follow-up interview. Endpoints to the study, for which participants were not re-interviewed, included households in the comparison district that began receiving similar food assistance from another organization after recruitment or individuals in either district initiating ART before follow-up, since the primary outcomes studied in the intervention were nutritional status and CD4 count, both of which could be affected by these developments [14]. The number of individuals becoming eligible for ART after recruitment may have been increased by changes in the World Health Organization (WHO) recommendations for ART eligibility based on CD4 counts made in 2010 [44]. We re-interviewed as many of these individuals as possible prior to receipt of outside food assistance or initiation of ART. When such prior interview was not feasible, the individual was considered lost to follow-up (Fig 1). Therefore, we did not interview all participants a full 12 months after recruitment—77% of study subjects at follow-up were re-interviewed between 10–13 months after their baseline interview, 15% were interviewed before 10 months (mean 8.2; standard deviation [SD] 1.8) and 8% after 13 months (mean 14.6; SD 2.2).

Bottom Line: We examined the impact of a food assistance intervention, previously shown to have reduced household food insecurity and improved nutritional status, on HRQoL of PLHIV.Over 12 months, food assistance significantly increased physical health scores (PHS) by 2.85 (P < .01) or approximately 0.35 SD, and reduced substantially the number of self- and healthcare provider-reported HIV-related symptoms by 3.83 and 2.68, respectively (P < .01).There was no significant impact, however, on mental health scores (MHS).

View Article: PubMed Central - PubMed

Affiliation: Department of Economics, Middlebury College, Middlebury, Vermont, United States of America.

ABSTRACT

Introduction: Widespread food insecurity in Africa continues to compromise an effective response to the AIDS epidemic. Health-related quality of life (HRQoL) is a comprehensive indicator of physical, mental, and social well-being that is associated with food insecurity and increasingly used to assess the well-being of people living with HIV/AIDS (PLHIV). We examined the impact of a food assistance intervention, previously shown to have reduced household food insecurity and improved nutritional status, on HRQoL of PLHIV.

Methods: We capitalized on an existing intervention targeting antiretroviral therapy (ART)- naïve PLHIV in Uganda, and conducted a prospective impact evaluation including a treatment and a comparison group. Data analyzed included 640 participants from two districts (318 in the intervention district) interviewed in both clinic and household settings at baseline and again approximately one year later. The main outcomes considered were physical and mental health dimensions of HRQoL, and other outcomes included self- and healthcare provider-reported symptoms. We utilized difference-in-difference propensity score matching methodologies to infer causality and examine program impacts.

Results: Over 12 months, food assistance significantly increased physical health scores (PHS) by 2.85 (P < .01) or approximately 0.35 SD, and reduced substantially the number of self- and healthcare provider-reported HIV-related symptoms by 3.83 and 2.68, respectively (P < .01). There was no significant impact, however, on mental health scores (MHS).

Conclusions: This study demonstrates the potential importance for HRQoL of including food assistance programming as part of the standard of care for PLHIV in areas of widespread food insecurity.

No MeSH data available.