Sex differences in health-related quality of life and poverty risk among older people living with HIV in Spain: A cross-sectional study

• Published in: PloS one 2024-05, Vol.19 (5), p.e0301335-e0301335
• Main Authors: Nuño, Néstor, Martínez, Alberto, Martínez, Susana, Cobos, Marta, Hernández, Juan Sebastián, Polo, Rosa
• Format: Article
• Language: English
• Subjects: Aged; Antiretroviral agents; Biology and Life Sciences; Chronic illnesses; Cross-Sectional Studies; Data collection; Demographic aspects; Employment; Environmental health; Epidemiology; Female; Gender differences; Health aspects; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; HIV patients; Human immunodeficiency virus; Humans; Infections; Life expectancy; Life span; Living conditions; Low income groups; Male; Medical diagnosis; Medical research; Medicine and Health Sciences; Medicine, Experimental; Men; Mental disorders; Middle Aged; Observational studies; Older people; Participation; People and places; Poverty; Public health; Quality of Life; Quantitative psychology; Questionnaires; Self report; Sex differences; Sex Factors; Sexually transmitted diseases; Social aspects; Social Sciences; Sociodemographics; Spain; Spain - epidemiology; Statistical analysis; Statistics; STD; Stigma; Surveys and Questionnaires; Variables; Women; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0301335

Current antiretroviral therapies have increased the life expectancy of people living with HIV (PLHIV). There is, however, limited evidence regarding the health-related quality of life (HRQoL) and living conditions of older people living with HIV (OPLHIV) in Spain. We implemented a self-administered online questionnaire to identify sex differences in HRQoL and poverty risk among Spanish OPLHIV (PLHIV ≥50 years). Participants were contacted through non-governmental organisations. We used the standardised WHOQoL-HIV BREF questionnaire and the Europe 2020 guidelines to estimate HRQoL and poverty risk respectively. The statistical analysis included multivariable generalised linear models with potential confounding variables and robust estimates. The study included 247 OPLHIV (192 men and 55 women). On the WHOQoL-HIV BREF questionnaire, men scored higher on 84% of items and in all six domains. Women had significantly lower HRQoL in five domains: physical health (β: -1.5; 95% CI: -2.5, -0.5; p: 0.002), psychological health (β: -1.0; 95% CI: -1.9, -0.1; p: 0.036), level of independence (β: -1.1; 95% CI: -1.9, -0.2; p: 0.019), environmental health (β: -1.1; 95% CI: -1.8, -0.3; p: 0.008), and spirituality/personal beliefs (β: -1.4; 95% CI: -2.5, -0.3; p: 0.012). No statistical differences were found in the domain of social relations. Poverty risk was considerable for both men (30%) and women (53%), but women were significantly more likely to experience it (OR: 2.9; 95% CI: 1.3, 6.5; p: 0.009). The aging of PLHIV is a public health concern. Our findings indicate that HRQoL and poverty risk among Spanish OPLHIV differ significantly by sex. Spain should, therefore, implement specific policies and interventions to address OPLHIV needs. The strategies must place a high priority on the reduction of sex inequalities in HRQoL and the enhancement of the structural conditions in which OPLHIV live.