Symptom Experience in HIV-Infected Adults: A Function of Demographic and Clinical Characteristics
Accepted 14 May 2009. published online 07 October 2009.
Abstract
Personal characteristics that interact with both HIV diagnosis and its medical management can influence symptom experience. Little is known about how symptoms in populations with chronic illness vary by age, sex, or socioeconomic factors. As part of an ongoing prospective longitudinal study, this report describes symptoms experienced by 317 men and women living with HIV/AIDS. Participants were recruited at HIV clinics and community sites in the San Francisco Bay Area. Measures included the most recent CD4 cell count and viral load from the medical record, demographic and treatment variables, and the 32-item Memorial Symptom Assessment Scale to estimate prevalence, severity, and distress of each symptom and global symptom burden. The median number of symptoms was nine, and symptoms experienced by more than half the sample population included lack of energy (65%), drowsiness (57%), difficulty sleeping (56%), and pain (55%). Global symptom burden was unrelated to age or CD4 cell count. Those with an AIDS diagnosis had significantly higher symptom burden scores, as did those currently receiving antiretroviral therapy. African Americans reported fewer symptoms than Caucasians or Mixed/Other race, and women reported more symptom burden after controlling for AIDS diagnosis and race. Because high symptom burden is more likely to precipitate self-care strategies that may potentially be ineffective, strategies for symptom management would be better guided by tailored interventions from health care providers.
aDepartment of Family Health Care Nursing, University of California, San Francisco, California, USA
bCommunity Health Systems, University of California, San Francisco, California, USA
cDepartment of Physiological Nursing, University of California, San Francisco, California, USA
dCardiovascular Research Institute, University of California, San Francisco, California, USA
eInstitute for Human Genetics, University of California, San Francisco, California, USA
fSchool of Nursing, San Francisco State University, San Francisco, California, USA
Address correspondence to: Kathryn A. Lee, RN, PhD, Department of Family Health Care Nursing, Box 0606, University of California, San Francisco, 2 Koret Way, Room N415Y, San Francisco, CA 94143-0606, USA.
This research was supported by a grant from the National Institute of Mental Health (NIMH 5R01 MH074358). Data collection was supported by the General Clinical Research Center in the UCSF CTSA (1 UL RR024131). Dr. Aouizerat is also supported by an NIH Roadmap K12 (KL2 RR024130), and Dr. Davis is supported by an NIH Research Infrastructure in Minority Institutions (RIMI) award (5P20 MD0005444).
ABSTRACT