Quality of Life Assessment and Related Factors of HIV-Infected Patients in Hangzhou Using a Path Analysis Model: An Observational Study

OBJECTIVE: This study aimed to examine which path among direct and indirect effects was more influential to the quality of life (QOL) for patients with human immunodeficiency virus (HIV). METHODS: An observational study among 951 individuals diagnosed with HIV was conducted in designated acquired immunodeficiency syndrome (AIDS) medical institutions in Hangzhou using simple random sampling technique. We collected the demographic data of patients and then evaluated their QOL by 12-Item Short-Form (SF-12) questionnaire survey. The two-stage least squares analysis was firstly performed to filter the independent influencing factors of Physical Component Summary (PCS) and Mental Component Summary (MCS). We then enrolled the PCS, MCS, and their influencing factors into the path analysis of QOL, and further revealed the direct and indirect effects of variables and examined the important path that was more influential on the patient’s QOL. RESULTS: The patient’s PCS, MCS, and quality of life showed a significant difference between groups in terms of education level and working condition (all P<0.05). Regression analysis showed that depression, age, education level, and treatment independently affected the PCS (all P<0.05), and depression and anxiety exerted an independent effect on the MCS (all P<0.05). Further path analysis integrating related variables showed that the main indexes of the goodness of fit implied the final model fit the data well. The path analysis showed that PCS and MCS exerted direct effects on the QOL (all P<0.001), especially the MCS (β=0.785), but other variables exerted no direct effects (all β=0, all P>0.05). It should be noted that anxiety presented an obvious indirect effect on the QOL (β=0.460), and its indirect effect was similar to the direct effect of PCS (β=0.471). CONCLUSION: The MCS might exert a more important effect on the QOL of HIV patients. In addition, the indirect effect of anxiety on the QOL should not be ignored.