The role of psychological and behavioral variables in quality of life and the experience of bodily pain among persons living with HIV

With increased life expectancy of individuals living with HIV, quality of life (QOL) has become a focus of treatment. More research is needed to address pain-related QOL and modifiable variables, such as health behaviors, depressive symptoms, and coping styles, which could be included in treatment protocols to improve QOL among individuals with HIV. Objectives of this study were to (1) examine relationships among health behaviors, psychological variables, and QOL, particularly pain-specific QOL, (2) examine the relationships among coping, depressive symptoms, and QOL, and (3) compare QOL scores of individuals with HIV and population-based normative data. HIV positive men and women not currently on highly active antiretroviral therapy were recruited during regular visits to an HIV outpatient clinic. They completed the Medical Outcome Study Health Survey SF-36 scale, which includes a physical components scale, a mental components scale, and a bodily pain subscale. They also completed questionnaires assessing health behaviors, depressive symptoms, and coping styles. Participants (n = 97) scored significantly lower on most aspects of QOL than age-matched Canadian and U.S. norms. Hierarchical multiple regressions revealed that physical activity and CD4 cell count were independently related to lower physical components scale scores; smoking and depressive symptoms were independently associated with lower mental components scale scores; and education, physical activity, and depressive symptoms were independently associated with lower pain-related QOL. Depressive symptoms mediated the relationship between coping styles and the mental components scale and pain-related QOL. Results suggest that targeting depressive symptoms, physical activity, and coping strategies as part of comprehensive treatment protocols could help improve pain-specific QOL and overall QOL among individuals with HIV.