Utility assessment of HIV/AIDS-related health states in HIV-infected Ugandans

Lara, Antonieta Medina, Wakholi, Barbara Nyanzi, Kasirye, Agnes, Munderi, Paula, Watera, Christine, Lalloo, David G., Haycox, Alan, Gilks, Charles F. and Grosskurth, Heiner (2008) Utility assessment of HIV/AIDS-related health states in HIV-infected Ugandans. Aids, 22 S1: S123-S130. doi:10.1097/01.aids.0000327633.85221.9a

Author Lara, Antonieta Medina
Wakholi, Barbara Nyanzi
Kasirye, Agnes
Munderi, Paula
Watera, Christine
Lalloo, David G.
Haycox, Alan
Gilks, Charles F.
Grosskurth, Heiner
Title Utility assessment of HIV/AIDS-related health states in HIV-infected Ugandans
Journal name Aids   Check publisher's open access policy
ISSN 0269-9370
Publication date 2008-07
Sub-type Article (original research)
DOI 10.1097/01.aids.0000327633.85221.9a
Open Access Status
Volume 22
Issue S1
Start page S123
End page S130
Total pages 8
Place of publication Philadelphia United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Objective: To assess the psychometric performance of using standard gamble (SG), time trade-off (TTO) and visual analogue scale (VAS) in the evaluation of three predetermined HIV/AIDS health states in HIV-infected Ugandans, for use in cost-effectiveness analyses.

Methods: We recruited participants with CD4 cells <200/µl from the Development of AntiRetroviral Therapy in Africa (DART) trial cohort [randomized trial evaluating antiretroviral therapy (ART) management strategies] in Uganda, before they initiated ART (n = 276). A comparison group of ART-naive HIV-infected individuals was recruited from the Entebbe Cohort study (n = 159). Participants were interviewed and asked to rate his/her own health state using VAS; rank and evaluate HIV/AIDS predetermined health states using TTO and SG relative to an improved health state. Tools were tested for psychometrical properties.

Results: Women constituted 64% and 76% of the DART and Entebbe Cohorts. Mean age was 36.5 and 36.7 years, respectively. Participants could discriminate between predetermined HIV/AIDS health states. Deterioration in health status was associated with a reduction in rating scores (VAS), increased willingness to give up time (TTO) and acceptance of increased risk (SG) to achieve a better health state, independent of the participant's actual health state, as measured by CD4 cell counts.

Conclusion: VAS, TTO and SG have good psychometric properties, making them good candidates for use in resource-constrained settings. Further research in a wider population is necessary to generate an evidence base with which to inform resource allocation decisions.
Keyword Hiv/aids
Standard gamble
Time trade-off
Visual analogue scale
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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