Quality of life and labour force participation in people living with HIV: The TREVI study in Barbados and The Netherlands

ABSTRACT

OBJECTIVE: The TREVI study compared cohorts of persons living with HIV in Barbados and The Netherlands to investigate the impact of living with HIV on health-related quality of life, cognitive functioning and labour force participation. SUBJECTS AND METHODS: Cross-sectional cohorts were recruited from the Ladymeade Reference Unit, Barbados (n = 129) and the Outpatient Clinic of Erasmus Medical Centre, Rotterdam, The Netherlands (n = 315). RESULTS: The Barbados cohort was younger (mean age 37years) and more gender mixed (58% male) than the Dutchcohort (48 years; 87% male). Both cohorts were well controlled with respect to viral load (> 90% undetectable HIV virus). Unemployment was similar (31% vs 35%) but Dutch respondents reported greater job satisfaction and less anxiety. The Barbadian cohort scored better in self reported quality of life, physical functioning, general health perception, happiness, cognitive functioning and depression. Dementia assessed on the International HIV Dementia Scale scale was equivalent (10.8 ± 1.0 vs 10.8 ±1.3). Dutch clients were more likely to have disclosed their status to sexual partners, family, or work colleagues. Barbadians were more likely to have been hurt by the reaction of friends to their HIV status (36% vs 17%). CONCLUSIONS: The TREVI study revealed higher perception of health, happiness and quality of life among an HIV cohort living in Barbados. Willingness to disclose HIV status and perceptions of stigma and workplace satisfaction were better among the Dutch cohort. Both recorded similar levels of educational attainment and unemployment. The social, workplace and psychological support needs of persons living with HIV are therefore distinct between these two countries.