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University of Cincinnati Academic Health Center
Publish Date: 08/03/99
Media Contact: AHC Public Relations, (513) 558-4553
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Researchers Find AIDS Patients Value Life

Cincinnati—Infection with the Human Immunodeficiency Virus (HIV) was once considered a death sentence, but is regarded now as more of a chronic disease like heart disease or diabetes. Results of a study led by principal investigator Joel Tsevat, MD, MPH, Section of Outcomes Research, Department of Internal Medicine, and the Institute for Health Policy and Health Services Research, University of Cincinnati (UC) Medical Center, were published in the August 3 Annals of Internal Medicine. The study showed that nearly half of the patients with HIV/AIDS said that their life was better now than before they had HIV/AIDS. In contrast, only 29 percent of the patients interviewed for this study said that it was worse, and on average, patients would give up no more than 5 percent of their remaining life expectancy in their current state of health in exchange for a shorter but healthy life. Factors contributing to life satisfaction and health values included spirituality and having children.

Approximately 650,000 to 900,000 people in the United States are infected with HIV. Recognizing the enormous burden, researchers are increasingly studying the quality of life in HIV-infected patients. This study measured the health values of patients with HIV/AIDS and found that despite compromised health, patients with HIV exhibited a strong will to live. Using life satisfaction and health value (utility) measures, the researchers examined how patients with HIV think about and value their health.

Between October 1996 and May 1997, Tsevat and colleagues conducted focus groups with 34 HIV-infected patients and in-depth, cognitive interviews with an additional 51 HIV-infected patients. Approximately half of the patients were taking the new protease inhibitor medications. The participants were also asked questions about their health status, spirituality, and attitudes toward family and friends. Finally they were asked to compare their present lives with their lives before they were diagnosed with HIV.

According to Tsevat, "Despite their compromised health, patients strongly preferred longevity to excellent health. Factors unrelated to health were often more important in predicting satisfaction with life and the will to live. The finding that half of patients felt that their life has gotten better could potentially lead to interventions to help patients who have not reached that stage."

This study was funded with grant support from the Agency for Health Care Policy and Research. Tsevat along with Karen Mandell, PharmD, Division of General Internal Medicine at UC; and, Judith McElwee, RN, Division of Infectious Diseases, Department of Internal Medicine, at UC Medical Center, collaborated with Cincinnatian Susan Sherman, DPA, SNS research; Frank Sonnenberg, MD, University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School; and Jack Fowler, Jr., PhD, University of Massachusetts at Boston.

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