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The Will To Live among HIV-Infected Patients

Joel Tsevat, MD, MPH; Susan N. Sherman, DPA; Judith A. McElwee, RN; Karen L. Mandell, PharmD; Loretta A. Simbartl, MS; Frank A. Sonnenberg, MD; and Floyd J. Fowler Jr., PhD
[+] Article, Author, and Disclosure Information

From the University of Cincinnati Medical Center and SNS Research, Cincinnati, Ohio; University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey; and University of Massachusetts at Boston, Boston, Massachusetts.

Note: Portions of this paper were presented at the 20th Annual Meeting of the Society of General Internal Medicine, Washington, D.C., May 1997, and the 19th Annual Meeting of the Society for Medical Decision Making, Houston, Texas, October 1997.

Acknowledgments: The authors thank Jill Leonard, RN, and Tonya Bess, LPN, for help with recruiting patients and Vickie Stringfellow and her staff for coding the in-depth interviews.

Grant Support: By the Agency for Health Care Policy and Research (1 R01 HS 09103-01).

Requests for Reprints: Joel Tsevat,MD, MPH, Section of Outcomes Research, Division of General Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267-0535; e-mail, Joel.Tsevat@uc.edu.

Current Author Addresses: Drs.Tsevat and Mandell and Ms. Simbartl: Section of Outcomes Research, Division of General Internal Medicine, Box 670535, University of Cincinnati Medical Center, Cincinnati, OH 45267-0535.

Dr. Sherman: SNS Research, 11120 Sycamore Grove Lane, Cincinnati, OH 45241.

Ms. McElwee: Infectious Diseases Center, Box670405, University of Cincinnati Medical Center, Cincinnati, OH 45267-0405.

Dr. Sonnenberg: Division of General Internal Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, 125 Paterson Street, Room 2312, New Brunswick, NJ 08903.

Dr. Fowler: Center for Survey Research, University of Massachusetts at Boston, 100 Morrissey Boulevard, Boston, MA 02125-3393.

Ann Intern Med. 1999;131(3):194-198. doi:10.7326/0003-4819-131-3-199908030-00006
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Background: Patients infected with HIV value both longevity and health.

Objective: To understand how HIV-infected patients value their health.

Design: Interview study.

Setting: Regional treatment center for HIV.

Patients: 51 patients with HIV infection.

Measurements: Life-satisfaction, health rating, time-tradeoff, and standard-gamble scores.

Results: Of the 51 patients, 49% (95% CI, 35% to 63%) said that their life was better currently than it was before they contracted HIV infection; only 29% said that life was currently worse. The mean (± SD)time-tradeoff score was 0.95 ± 0.10, indicating that, on average, patients would give up no more than 5% of their remaining life expectancy in their current state of health in exchange for a shorter but healthy life. The average health rating score was 71.0 ± 18.7 on a scale of 0 to 100, and the average standard-gamble score was 0.80 ± 0.27. Factors contributing to life satisfaction and time-tradeoff scores included spirituality and having children.

Conclusion: Many patients with HIV have a strong will to live, and many feel that life with HIV is better than it was before they became infected.


hiv ; spirituality





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