Impact of HIV infection on self-rated health in a high-prevalence popolation with low awareness of own HIV status

Abstract

Background: Self-rated global health status has been found to be a sensitive marker of declining health and to operate as an independent predictor of survival. This study examines the effect of HIV infection on self-rated health in a population with high prevalence of HIV infection and low awareness of own status of HIV infection. Methods: The data stem from a comprehensive population-based HIV survey conducted in selected urban and rural populations in Zambia in 1996. A total of 1951 males and 2158 females of age more than 14 years were interviewed of which 6% refused to be tested for HIV infection. A logistic regression model was used assuming socio-demographic factors, mental distress and health care use to be associated both with HIV infection and self-rated health. Results: The proportion of persons judging their health status as poor was higher in the rural than in the urban population. Generally no major difference in the proportions of persons rating their health status as poor was observed between sexes. The proportion of poor self-rated health status increased linearly with age. Use of health care services, mental distress and self-perceived risk of HIV infection were negatively associated with self-rated health. Both males and females living in an urban area and males living in a rural area of age more than 24 years who were infected with HIV were about twice as likely to rate their health status as poor compared to respondents who were not infected with HIV. Conclusion: HIV infection had a strong independent negative effect on self-rated health in persons of age greater than 24 years. This measure of people’s subjective health may be used as a valuable “diagnostic” tool in HIV-related care and support programmes, and should be evaluated for use in such services.