Degree Name

PHD, Doctor of Philosophy

Degree Type

Dissertation - Open Access

Department

College of Social Work

Advisory Committee

Bruce A. Thyer

Date

April 2012

Abstract

Background: Individuals living in rural areas may experience challenges in accessing affordable and appropriate medical care and support, often resulting in declines in health related quality of life. This is especially true for individuals diagnosed with HIV disease. While only one third of the US population lives in the south, over two thirds of all rural AIDS cases occur in this region. Fewer than 1,500 individuals are reported to be living with HIV/AIDS in the northern region of Florida commonly referred to as the Big Bend area. This predominantly rural region includes the eight counties located between the Gulf of Mexico and the Florida-Georgia border.

Purpose: The purpose of this dissertation was to identify the health-related quality of life (HRQoL) status of people living with HIV/AIDS (PLHA) in the Big Bend area who receive case management services.

Questions: The following questions are addressed:

1. What is the HRQoL status for PLHA residing in the Big Bend area receiving case management services?

2. How much do previously identified correlates account for variances in HRQoL among PLHA residing in the Big Bend area?

Method: A cross-sectional descriptive survey method assessed the demographic characteristics and HRQoL variables for approximately 97 PLHA who reside in the Big Bend area and receive case management. Group comparisons were made based on demographic and socioeconomic status characteristics, behavioral factors, disease status, symptom status, and functional status.

Significance: The results reveal that PLHA who receive HIV case management in the Big Bend area have mild symptom burdens, are only mildly functionally impaired, yet have poor quality of life. Few group differences were observed. Three significant findings were present. First, among PLHA who take highly active antiretroviral treatment (HAART), those with AIDS reported more concerns about the impact that HIV medications have had on their life than those who do not have AIDS. Secondly, those who report using tobacco products are less satisfied with their life than tobacco non-users and, more interestingly, those who report using tobacco products are less accepting of their HIV status than those who do not use tobacco, even when controlling for other variables. And finally, those who report using illicit drugs have significantly more concerns about family, friends, and coworkers finding out about their HIV status than those who do not report using illicit drugs. Implications for HIV case management and social work policy and practice are discussed.

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