Study characteristics on health-related quality of life in older people living with human immunodeficiency virus: A narrative review

Table 1 Summaries of study characteristics on health-related quality of life in older people living with human immunodeficiency virus including the narrative review

Study	Demographics			Methods		Outcomes1
	Ref.	Sample (Female, %)	Age groups (Number of the sample)	Objectives	Study design; Conceptual framework; Terminology; Instrument	HRQoL; QoL; PHS; MHS
1	Piette et al[24], the United States	369 (15.2)	< 30 (88); 30-39 (192); 40-49 (71); 50+ (18) 4.9%	Examined the impact of age on QoL (independent of HIV stage and symptoms)	CSS; NA; QoL; MOS-HIV (20 items)	QoL (PF, RF, SF, mental health, health perceptions, and pain subscales)
2	Crystal et al[104], the United States	2836 (29.5)	18-29 (376); 30-39 (1171); 40-49 (1007); 50+ (282) 9.9%	Characterized adults with HIV's physical and role limitations	CSS; NA; NA; SF-21	Other (9-item), RF (2-item)
3	Hays et al[56], the United States	2864 represented 231400 (23.0)	18-29 (29540); 30-34 (49562); 35-39 (54956); 40-44 (43812); 45-49 (27105); 50+ (26438) 11%	Measured HIV patients' HRQoL in comparison to those with other comorbidities	CSS; NA; HRQoL; SF-36	PHS, MHS
4	Kalichman et al[50], the United States	113 (24.8)	45+ (45-54) 66%	Evaluated suicidal thoughts among mid-age and older persons with HIV	CSS; NA; HRQoL; FAHI-55	HRQoL (physical well-being, emotional well-being, and functional well-being, and provider relationship)
5	Campsmith et al[105], the United States	3778 (26.5)	18-29 (605); 30-39 (1783); 40-49 (1055); 50+ (335) 8.9%	Described levels of HRQoL in different demographic and behavioral risk factor groups	CSS; NA; HRQoL; MOS	HRQoL (PF, RF, SF, CF, mental health, overall health, pain, and energy/fatigue)
6	Crystal et al[35], the United States	2857 (Non-heterosexual men, injection drug users & others)	< 50 (2573); 50+ (284) 9.9%	Provided a national profile of socioeconomic circumstances of the mid-aged and older populations with HIV	CSS; NA; QoL; QoL Indicators	QoL (overall QoL, GH, PF, RF, SF, emotional well-being)
7	Lyons et al[37], Australia	693 (Non-heterosexual men)	18-35 (101); 36-50 (394); 50+ (198) 28.6%	Explored the health and psychological well-being of older Non-heterosexual Australians men with HIV compared with mid- and younger age	CSS; NA; Well-being; Not specific	Other (Physical health, mental health, psychological well-being)
8	Nokes et al[40], the United States (plus other four countries)	1217 (31.4)	< 50 (964); 50+ (232) 19.1%	Evaluated whether the chronological age affects symptom status and HRQoL in adults living with HIV	CSS; Wilson and Cleary; HRQoL; HAT-QoL-34	HRQoL (overall function, life satisfaction, health worries, financial worries, medication concerns, HIV mastery, disclosure worries, provider trust, and sexual function)
9	Pereira et al[41], Portuguese	1191 (32.6)	< 34 (305); 35-44 (558); > 45 (328) 27.5%	Determined gender and age differences on the QoL domains in Portuguese HIV-infected individuals	CSS; NA; QoL; WHOQOL-HIV-BREF	QoL (physical, level of independence, social, environmental, spirituality & psychological subscales)
10	Shan et al[106], China	1009 (56.4)	< 40 (351); 40-49 (444); 50+ (214) 21.2%	Evaluated the QoL and related factors in HIV-positive spouses from serodiscordant couples under antiretroviral therapy	CSS; NA; QoL; WHOQOL-HIV-BREF (China version)	QoL (physical, social, environmental & psychological domains)
11	Balderson et al[107], the United States	452 (27.7)	50-54 (265); 55-59 (129); 60+ (58)	Assessed the relationship of comorbid chronic illnesses to physical, social, and mental health functioning in a nine-state community sample of HIV-positive older adults	CSS; NA; QoL; SF-36 (3 subscales)	QoL (PF, SF, mental health subscales)
12	Doyle et al[108], the United States	113 (17.7)	< 40 (41); 50+ (72) 63.7%	Investigated the association between prospective memory and HRQoL by age group	CSS; NA; HRQoL; SF-36 (8 subscales)	PHS, MHS
13	Lyons et al[38], Australia	189 (Non-heterosexual men)	40-44 (54); 45-49 (57); 50-54 (39); 55+ (39)	Examined differences in physical and mental health between HIV-positive and HIV-negative non-heterosexual men across age groups	CSS; NA; Well-being; K10 of psychological distress	Other (mental health condition)
14	Morgan et al[31], the United States	92 (18.5)	< 40 (31); 50+ (61) 66.3%	Determined whether HIV infection and aging act synergistically to disrupt everyday functioning, compared between HIV-positive and HIV-negative individuals	CSS; None; HRQoL; SF-36 (8 subscales)	PHS, MHS (physical well-being, mental well-being) plus Instrumental Activity of Daily Living (IADL)/Basic Activities of Daily Living (BADL)
15	Nyirenda et al[66], South Africa	203 (NA)	50-59 (136); 60-69 (55); 70+(12)	Examined correlates of health and well-being in HIV-positive older people compared to HIV-negative peers in rural South Africa	CSS; NA; QoL; WHOQOL-HIV BREF	PHS, MHS (functional ability, QoL/subjective well-being & health state subscales)
16	Skevington et al[42], Multi-countries	2089 (37.0)	<40 (1689); 40+ (403) 19%	Investigated QoL in persons living with HIV using multicultural countries data [p. 1220]	CSS; NA; QoL; WHOQOL-HIV BREF	QoL (physical, social, psychological, independence, environment & spiritual domains)
17	Emlet et al[49], the United States	226 (Non-heterosexual men)	50-86	Identified risk and protective factors associated with physical- and mental-HRQoL in non-heterosexual men living with HIV	CSS; Resilient theory; HRQoL; SF-36 (8 subscales)	PHS, MHS
18	Gard et al[45], Rwanda	705 (100.0)	< 30 (158); 30-40 (389); 41+ (158) 22.4%	Examined the association between HIV disease progression and HRQoL among Rwandan women who were HIV-positive compared to HIV-negative women	CSS; NA; HRQoL; SF-12 (8 items)	HRQoL (PF, RF, SF, CF, pain, emotional well-being, health perceptions & QoL subscales)
19	Rodriguez-Penney et al[109], the United States	141 (32.4)	≤ 40 (50); 50+ (91) 64.5%	Characterized the association between comorbidity burdens and HRQoL in both younger and older adults living with HIV	CSS; NA; HRQoL; SF-36 (8 subscales)	PHS, MHS
20	Slater et al[32], the United States	60 (Non-heterosexual men)	50-65 (100)	Explored the relationships among age, race, SES, social support, and social stigma in QoL	CSS; NA; QoL; HAT-QoL (34 items)	QoL
21	Douab et al[28], France	4339 (NA)	18-29 (260); 30-39 (1175); 40-49 (1593); 50+ (1308) 59%	Determined and compared the levels and patterns of correlates of HRQoL in adults living with HIV in the cohort of 8-year follow-up	Follow-up study (FUS); NA; HRQoL; SF-36 & SF-12	PHS, MHS (SF-36 & SF-12)
22	Moore et al[110], the United States	177 (16.4)	≤ 40 (40); 50+ (60)	Determined the relationship of successful cognitive aging to mental- and physical-HRQoL	CSS; NA; HRQoL; SF-36	PHS, MHS
23	Allshouse et al[111], the United States	359 (15.3)	45+ (359)	Determined the impact of self-reported marijuana use on successful aging	CSS; NA; HRQoL/QoL; SF-36	QoL (all domains)
24	Fang et al[68], the United States	299 (32.4)	50+ (100)	Tested the role of resilience as a mediator between life stress and HRQoL	CSS; NA; HRQoL; Revised FAHI QoL (physical, emotional, social, functional/global, and cognitive functioning well-being)	QoL (physical well-beingemotional well-being, functional/global well-being, social well-being, & cognitive functioning)
25	Fumaz et al[64], Spain	151 (42.4)	45+ (151)	Evaluated resilience, perception of aging, coping strategies, and QoL	CSS; NA; QoL; Nottingham Health Profile (NHP)	QoL (pain, energy, sleep, physical mobility, emotion reactions, social isolation, occupation, life affected by housework, family life)
26	Lifson et al[112], Multi-countries	4119 (22.9)	< 30 (29); 30-39 (34); 40-49 (25); 50+ (11)	Reported results of QoL assessments	CSS; NA; QoL; SF-12	QoL
27	Mekuria et al[78], the Netherlands	664 (63.6)	≤ 37 (362); > 37 (299)	Investigated the level of HRQo with associated predictors	CSS; NA; HRQoL; WHOQOL-HIV BREF	HRQoL (physical, social, psychological, spiritual, environment & independence domains)
28	Okuno et al[60], Brazil	201 (36.3)	50+ (201)	Evaluated QoL and its connections to socioeconomic profile, sexual knowledge, and sexual attitudes	CSS; NA; QoL; HAT-QoL (34 items)	QoL (overall function, life satisfaction, health worries, financial worries, medication worries, HIV mastery, disclosure worries, provider trust & sexual function)
29	Slater et al[33], the United States	60 (Non-heterosexual men)	50-65 (60)	Explored the relationships among social stigma, SES variables, social support, coping, and QoL	CSS; NA; QoL; HAT-QoL (34 items)	QoL
30	Brown et al[29], the United Kingdom	92 (18.5)	32+ (92)	Evaluated rehabilitation interventions (referrals, adherence & outcomes)	FUS; Self- management programme; HRQoL; FAHI	QoL (physical well-being, emotional well-being, functional well-being, social well-being, & cognitive functioning)
31	Ezeamama et al[53], Uganda	400 (69.3)	≤ 25 (57); 26-35 (144); 36-45 (142); 46+ (57) 14.3%	Evaluated perceived social standing (PSS) as a determinant of health outcomes	FUS; Perceived social standing (PSS); QoL; MOS-HIV	QoL
32	George et al[51], Ireland	521 (30.7)	< 50 (447); 50+ (74) 14%	Assessed HRQoL and its associations with socioeconomic, behavioural, clinical, nutrition-related factors, and social support	CSS; Wilson-Cleary; HRQoL; MOS-HIV (35 items)	PHS, MHS
33	Monteiro et al[67], Portugal	1194 (32.5)	< 50 (1015); 50+ (179) 15%	Examined age-related differences in QoL, and the association between sociodemographics, HIV-related variables, depressive symptoms, and QoL domains	CSS; NA; QoL; WHOQOL-HIV BREF (31 items)	QoL (physical, psychological, level of independence, social relationships, environment & spirituality)
34	Catalan et al[25], the United Kingdom	100 (27.0)	50+ (100)	Examined self-reported QoL, social supports, and mental health	CSS; NA; QoL; WHOQOL-HIV BREF	QoL (physical, psychological, level of independence, social relationships, environment, spirituality & total QoL)
35	Emlet et al[48], the United States	335 (Non-heterosexual men)	50+ (100)	Examined how HIV-related factors, adverse conditions, psychosocial characteristics, and their associations with resilience and mastery	CSS; NA; HRQoL; WHOQOL-HIV BREF	Other (psychological domain)
36	Emuren et al[61], the United States	1668 (7.0)	18+ (1668)	Determined the factors associated with HRQoL	FUS; NA; HRQoL; SF-36	PHS, MHS
37	Majeed et al[30], the United States	65 (36.9)	45+ (65)	Examined the relationship between basic psychological needs, depression, and QoL	CSS; Barron and Kenny Mediation; QoL; SF-36	QoL (all domains)
38	McGowan et al[39], the United Kingdom	3258 (19.6)	< 30 (172); 30-39 (745); 40-49 (1370); 50-59 (689) 21.6%; 60+ (214) 6.7%	Assessed the association of age with the prevalence of: Physical symptoms, depression or anxiety, and health-related functions, taking into account time since HIV diagnosis	CSS; NA; QoL; EuroQoL-5D-3 L	HRQoL (health-related functions of mobility, self-care & daily activities)
39	Millar et al[54], the United States	114 (32.5)	50+ (114)	Examined the associations between physical health, psychological health, overall health, and substance use	CSS; Biopsychosocial model; QoL; MOS-HIV (35 item)	QoL (all subscales)
40	Venturini et al[26], Italy	943 (34.1)	≤ 40 (114); 40-50 (364); 50-60 (376) 38.6%; 60+ (121) 12.8%	Assessed HRQoL of HIV-infected people	CSS; NA; HRQoL; EuroQoL-5D-3 L	HRQoL (mobility, self-care, usual activities, pain & anxiety/depression dimensions)
41	Vincent et al[71], the United States	299 (31.8)	50+ (100)	Investigated how HIV-related shame is associated with HRQoL	CSS; NA; HRQoL; FAHI (47 items)	HRQoL (physical well-being, emotional well-being & social well-being)
42	Yeoh et al[34], Australia	80 (NA)	50+ (100)	Assessed the frailty index in relation to QoL in older HIV-positive	CSS; NA; QoL; SF-36	QoL (all domains)
43	Biraguma et al[82], Rwanda	794 (64.6)	18-30 (240); 31-40 (245); 41-45 (204); 50+ (105) 13.2%	Determined the association between HRQoL and behavioural and biological risk factors	CSS; NA; HRQoL; MOS-HIV (35 items)	PHS, MHS
44	Ferreira et al[58], Brazil	226 (48.2)	< 40 (82); 40-49 (72); 50-59 (56) 24.8%; 60+ (16) 7%	Evaluated QoL and its predictors	CSS; NA; QoL; WHOQOL-HIV BREF	QoL (physical, psychological, independence, social relation, environment & spirituality dimensions)
45	Greene et al[65], the United States	356 (15.0)	50+ (356)	Determined the association of loneliness with functional impairment and HRQoL	CSS; NA; HRQoL; Patient Health Questionnaire	HRQoL
46	Nguyen et al[113], the United States	176 (25.0)	50+ (176)	Examined the relationship between risk/protective factors and Self-reported Health Status (SHHS) and Healthy Days Index (HDI)	CSS; NA; HRQoL; SRHS/HDI	HRQoL
47	Xu et al[43], China	197 (28.4)	50+ (197)	Assessed the interrelationship among resilience, coping, family, support, and QoL	CSS; NA; QoL; Chinese QoL scale (6 items)	QoL (Physical health, psychological health, economic circumstance, work/housework, family relationships & non-family relationships)
48	Castro et al[114], Brazil	1480 (35.3)	<30 (187); 30-39 (395); 40-59 (777); 60+ (121) 8.2%	Assessed HRQoL and its associated factors	CSS; NA; HRQoL/QoL; EuroQoL-5D-3 L	HRQoL
49	Fuster-RuizdeApodaca et al[69], Spain	467 (26.6)	≤ 49 (146); 50+ (229) 48.6%	Evaluated the influence of patient experience on HRQoL	CSS; NA; HRQoL; EuroQoL-5D-3 L /self-rate of health (EQ-VAS)	HRQoL
50	Jang et al[36], the United States	614 (3.3)	< 50 (307); 50+ (307) 50%	Assessed the relationship between QoL, age, and other demographic and clinical factors	CSS; NA; QoL; SF-12	HRQoL
51	Olson et al[115], the United States	296 (32.4)	50+ (296)	Assessed associations among physical symptoms, HIV-related health status, depressive symptoms, and HRQoL	CSS; NA; HRQoL; FAHI (47 items)	HRQoL (physical well-being, emotional well-being, social well-being, functional/global well-being, and cognitive functioning)
52	Rooney et al[116], the United States	122 (16.4)	36-45 (39); 46-55 (43); 56-65 (40) 32.8%	Assessed the relationship between depressive symptoms and other psychological factors across age decades	CSS; NA; HRQoL; SF-36	PHS, MHS
53	Tierney et al[63], the United States	12 (15.1)	≤ 40 (83); 50+ (109) 56.8%	Examined the effects of age on the expression of motor signs in people living with HIV	FUS; NA; QoL; SF-36	HRQoL
54	Xiao et al[117], China	522 (55.2)	< 45 (192); 45-54 (182); 55+ (148) 28.4%	Evaluated physical- and mental-HRQoL of people living with HIV in rural China, and the relationship between HRQoL and individual and family level factors	CSS; NA; HRQoL; MOS-HIV (35 items)	PHS, MHS
55	Brañas et al[59], Multi-countries	1126 (25.2)	50+ (1126)	Evaluated differences between older women and men (50+) with HIV in HIV variables, comorbidities, physical functions, and QOL	CSS; NA; QoL; EuroQoL-5D-3 L	QoL
56	Drewes et al[55], Germany	48 (12.3)	50-59 (541); 60-69 (158); 70+ (49)	Analyzed the role of SES as a predictor of health outcomes and HRQoL among people aging with HIV	CSS; NA; HRQoL; SF-12 (German version)	PHS, MHS
57	Ellis et al[16], the United States	78 (17.9)	Mean age = 55.3	Evaluated the impact of inflammation in aging people living with HIV on depressed mood	FUS; NA; QoL; MOS-HIV (35 items)	QoL
58	Fazeli et al[57], the United States	174 (38.0)	< 50 (71); 50+ (103) 59%	Determined the frequency and clinical correlates of successful functional aging (SFA)	CSS; NA; HRQoL; MOS-HIV (35 items)	PHS, MHS
59	Harris et al[18], Canada	834 (15.2)	Mean age = 53	Estimated the extent to which loneliness has associations with brain health, general health outcomes, and QoL among mid-aged and older HIV adults	CSS; Wilson & Cleary; HRQoL/QoL; EuroQoL-5D-3 L /SF-6/ WHOQOL-HIV BREF	Other (EuroQoL-5D-3 L /SF-6) & QoL (WHOQOL-HIV BREF)
60	Mayo et al[70], Canada	707 (NA)	35-44 (99); 45-54 (328); 55-59 (123) 17.4%; 60-81 (153) 21.6%	Estimated the extent to which HIV-related variables, cognition, and other brain health factors interrelate with other HIV-associated symptoms to influence function, health perception, and QoL in older HIV men	CSS; Wilson & Cleary; Biopsychosocial; QoL; EuroQoL-5D-3 L/SF-36/WHOQOL-HIV BREF	PHS, MHS
61	Parish et al[47], the United States	1526 (100.0)	≤ 50 (723); 50+ (803) 52.6%	Examined how having unmet dental needs, as well as other demographics, behavioural, and clinical variables, affects the oral HRQoL	CSS; NA; HRQoL (oral-HRQoL)	Other
62	Rubtsova et al[19], the United States	63 (38.1)	Mean age = 50.1	Examined the independent effects of neurocognitive impairment (NCI) and frailty on HRQoL	CSS; NA; HRQoL; SF-36	PHS, MHS
63	Musumari et al[62], Thailand	327 (61.2)	50-54 (119); 55-59 (121); 60-64 (70); 65+ (42)	Determined predictors of change in HRQoL over time among older HIV adults	FUS; NA; HRQoL; MOS-HIV (35 items)	PHS, MHS
64	Patel et al[27], the United States	41 (39.0)	45+ (41)	Determined the effects of mood disturbances, cognitive and motor symptoms on activities of daily living (ADLs) and QoL in older people living with HIV	CSS; NA; QoL; SF-12	QoL
65	Cabrera et al[44], Peru	175 (100.0)	45+ (175)	Examined HRQoL among a group of mid-aged and older women	CSS; NA; HRQoL; SF-36	PHS, MHS
66	Guaraldi et al[17], Italy	575 (NA)	Mean age = 54.8	Characterized resilience (frailty-resilience phenotypes), which affect HRQoL in people living with HIV	CSS; NA; HRQoL; EuroQoL-5D-3 L /SF-36	HRQoL
67	Okhai et al[46], the United Kingdom	813 (100.0)	45-49 (382); 50-54 (291) 35.8%; 55-59 (88) 10.8%	Evaluated HRQoL in a sample of PLHW women aged 45-60 years	CSS; NA; HRQoL; EuroQoL-5D-3 L	HRQoL
68	Pope et al[118], the United States	261 (35.6)	39+ (261)	Assessed the association between perceived transportation needs and contributors with health outcomes and HRQoL	CSS; NA; HRQoL; MOS-HIV (35 items)	HRQoL (GH, pain, SF, HD, health transitions subscales)

¹Measuring as a subscale, total scores, or summary scores. CSS: Cross-sectional study; CF: Cognitive functioning; EuroQoL-5D-3 L: European QoL 5-Dimension 3-level version; FAHIQoL: Functional Assessment of HIV Infection Quality of Life; FUS: Follow-up study; GH: General Health; HAT-QoL: HIV/AIDS-target quality of life; HD: Health Distress; HDI: Healthy Days Index; HRQoL: Health-related quality of life; MHS: Mental-HRQoL summary; MOS-HIV: Medical Outcomes Study HIV Health Survey; NA: Not available; PF: Physical functioning; PHS: Physical-HRQoL summary; QoL: Quality of life; RF: Role functioning; SES: Socioeconomic status; SF survey: Short form survey; SF: Social functioning; SHHS: Self-reported Health Status; The EQ-VAS: EuroQol Visual Analogue Scale.