Self-Management Model fails to Predict Quality of Life for People Living with Dual Diagnosis of HIV and Diabetes

Julie Ann Zuñiga, Adam Sales, Dong Eun Jang, Chelsi West Ohueri, Greer Burkholder, Richard Moore, Thibaut Davy-Méndez, Katerina Christopoulos, Alexandra A. García

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of this study was to test a self-management model for self-management in people living with HIV and type 2 diabetes (PLWH + T2DM). We conducted a predictive, longitudinal study of data from a national research cohort of PLWH using lag analysis to test short- and long-term health outcomes for PLWH + T2DM. We used a dataset from the Center for AIDS Research (CFAR) Network of Integrated Clinic Systems (CNICS), a nation-wide research network of 8 clinics that serves PLWH. Patient-reported outcomes, collected at clinic visit, included depression, adherence, CD4 cell count, and health-related quality of life (HRQoL). We computed summary statistics to describe the sample. Using lag analysis, we then modeled the three variables of adherence, CD4 count, and HRQoL as a function of their predecessors in our conceptual model. In the final model, an increase of in medication adherence corresponded to a small increase in HRQoL. An increase in CD4 count corresponded to a small increase in HRQoL. An increase in lagged depression was associated with a small decrease in HRQoL. The model was not sufficient to predict short- or long-term outcomes in PLWH + T2DM. Although depression had a moderate impact, the final model was not clinically significant. For people with a dual diagnosis of HIV and T2DM, variables other than those traditionally addressed in self-management interventions may be more important.

Original languageEnglish (US)
JournalAIDS and behavior
DOIs
StateAccepted/In press - 2021

Keywords

  • Adherence
  • Depression
  • Diabetes
  • HIV
  • Lag analysis
  • Quality of life
  • Self-management
  • Syndemic

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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