Health-related quality of life in HIV-infected patients: The role of substance use

P. Todd Korthuis, Laurie C. Zephyrin, John A. Fleishman, Somnath Saha, Joshua S. Josephs, Moriah M. McGrath, James Hellinger, Kelly A. Gebo

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


HIV infection and substance use disorders are chronic diseases with complex contributions to health-related quality of life (HRQOL). We conducted a cross-sectional survey of 951 HIV-infected adults receiving care at 14 HIV Research Network sites in 2003 to estimate associations between HRQOL and specific substance use among HIV-infected patients. HRQOL was assessed by multi-item measures of physical and role functioning, general health, pain, energy, positive affect, anxiety, and depression. Mental and physical summary scales were developed by factor analysis. We used linear regression to estimate adjusted associations between HRQOL and current illicit use of marijuana, analgesics, heroin, amphetamines, cocaine, sedatives, inhalants, hazardous/binge alcohol, and drug use severity. Current illicit drug use was reported by 37% of subjects. Mental HRQOL was reduced for current users [adjusted β coefficient -9.66, 95% confidence interval [(CI]) -13.4, -5.94] but not former users compared with never users. Amphetamines and sedatives were associated with large decreases in mental (amphetamines: β = -22.8 [95% CI -33.5, -12.0], sedatives: β = -18.6 [95% CI -26.2, -11.0]), and physical HRQOL (amphetamines: β = -11.5 [95% CI -22.6, -0.43], sedatives: β = -13.2 [95% CI -21.0, -5.36]). All illicit drugs were associated with decreased mental HRQOL: marijuana (β = -7.72 [95% CI -12.0, -3.48]), non-prescription analgesics (β = -13.4 [95% CI -20.8, -6.07]), cocaine (β = -10.5 [95% CI -16.4, -4.67]), and inhalants (β = -14.0 [95% CI -24.1, -3.83]). Facilitating sobriety for patients with attention to specific illicit drugs represents an important avenue for elevating HRQOL in patients living with HIV.

Original languageEnglish (US)
Pages (from-to)859-867
Number of pages9
JournalAIDS Patient Care and STDs
Issue number11
StatePublished - Nov 1 2008

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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