Analysis of survival in HIV-infected subjects according to socio-economic resources in the HAART era

Availability of Highly Active Anti-Retroviral Treatment (HAART) has modified the natural history of HIV infection, resulting in increase of seropositive subjects survival. The aim of the study was to assess patients' survival in relation to socio-economic status in HAART era using Functional Multidimensional Evaluation questionnaire. A three-level Socio-Economic Index (SEI) combining results from self-perception of unmet needs and objective data from the assessment of the two dimensions has been set up by the authors. Of the 382 subjects interviewed, 102 had been lost to follow-up. SEI showed that 66.4% of the sample faced unmet social or economic needs and 17.1% had unmet needs in both areas. There was a significant relationship between the self-sufficiency in performing Activities of Daily Living (ADL), Clinical Staging, CD4 cell count, SEI and risk of death. The lowest level of SEI was associated with a doubled risk of death compared to SEI upper level. Availability of social and economics support have a positive effect upon survival in patients with HIV infection, also in case of availability of HAART. The combination of subjective and objective assessment of socio-economic resources allows a better understanding of their impact on survival.