The Contribution of Guarding on Quality of Life Among Chilean People with HIV

This dissertation examined two interrelated clinical issues regarding the quality of life of people living with HIV: guarding and HIV-related symptoms. A cross-sectional study of 209 people living with HIV was conducted in Santiago, Chile. Participants completed a questionnaire about their quality of life, HIV symptom status, social network, demographics, and guarding. Illness characteristics were obtained from medical records. Guarding is a self-care process used by individuals in managing chronic illness; it refers to the process of maintaining vigilance over a person’s self and network. The first study evaluated the relationship between quality of life and guarding among people living with HIV. In a hierarchical multiple regression, more close friends/relatives, fewer HIV symptoms, and less guarding were significantly related to a higher quality of life. No relationship between quality of life and demographics or illness characteristics was found. All the above variables explained 58.8% of the variation in quality of life. The negative relationship between guarding and QOL may be due to the psychological effort that people living with HIV expended in guarding themselves and their network from their HIV condition. Among the greatest concerns of people living with HIV are HIV-related symptoms, even for those receiving excellent HIV care and free antiretroviral therapy. There are no published studies of symptoms among Chilean people living with HIV. The purpose of the second study was to determine the variables associated with the number of HIV-related symptoms and determine socio-demographic and/or clinical differences between patient clusters. In multivariate analysis, the number of HIV-related symptoms was related to number of years living with HIV and having completed college-level education. None of the other predictors were correlated with the number of HIV-related symptoms. HIV-related symptoms with the highest prevalence were fear/worries (66%), anxiety (52%), gas/bloating (50%), and thirst (50%). For the clusters analysis, people living with HIV who had completed a college education were twice as likely to be classified in the subgroup with mild intensity of HIV-related symptoms as participants without a college education. Failure to assess for HIV symptom status can compromise long-term HIV treatment goals.