The associations among coping, nadir CD4+ T-cell count, and non-HIV-related variables with health-related quality of life among an ambulatory HIV-positive patient population

We investigated HRQoL among HIV-positive outpatients from October, 2006-December, 2007, incorporating medical chart review,
and a survey of coping styles.

Consented HIV-positive patients receiving medical care at University of Colorado Denver, with HAART as first antiretroviral
regimen, completed the MOS-HIV and Brief COPE survey instruments. Linear regression identified a priori factors hypothesized
to be associated with the MOS-HIV composite mental and physical health scores (MHS, PHS). Brief COPE survey maladaptive and
adaptive coping components were added to the models and retained if significant.

Among the 157 patient cohort, parsimonious multivariable linear regression models (P < 0.05) indicated higher nadir CD4+ T-cell counts and adaptive coping were associated with a higher MHS; public/no insurance,
mental illness, current number of non-HIV medications, and maladaptive coping were inversely associated with MHS. Nadir CD4+
T-cell count and efavirenz use were associated with a higher PHS; mental illness, current number of non-HIV mediations, and
maladaptive coping were inversely associated with PHS.

Factors independently associated with lower MHS and lower PHS include lower nadir CD4+ T-cell counts, and use of maladaptive
coping. Efforts to reduce use of maladaptive coping strategies and earlier identification and treatment of HIV may improve
HRQoL in HIV-positive patients.