Self-rated Health among HIV-infected People Receiving Treatments in Thailand

Few studies have investigated the impact of antiretroviral treatment on the self-rated health of people living with HIV/AIDS. Self-rated health provides a global assessment of an individuals’ health status, encompassing several dimensions that no other single health outcome is able to capture. In this paper, we investigate the self-rated health of HIV-infected people receiving antiretroviral treatment at two different time-points, the time of interview and the time of antiretroviral initiation. A life-event history survey was carried-out among 513 HIV-infected individuals receiving treatment in four community hospitals in Chiang Mai province, Northern Thailand. Interviews cover their family, residential, education, occupation and health history including self-rated health over their lifespan. The proportion of participants reporting poor or very poor health decreased dramatically from 56% before treatment initiation to 6% at the time of interview. This huge improvement in self-rated health paralleled with clinical and biological markers. At the time of interview, factors independently associated with better self-rated health were the absence of symptoms and an immunological recovery (Odd Ratios (OR): 2.22 and 1.52, respectively). At treatment initiation, the absence of symptoms, of severe immunosuppression and no history of hospitalization were independently associated with better self-rated health (OR: 2.22, 1.52, and 3.11, respectively). These results confirm the validity of the self-rated health indicator in the particular context of HIV/AIDS.