Introduction of advanced management and treatment of HIV/AIDS has seen life expectancy of
people living with HIV/AIDS (PLWHA) increase over the years to almost the level of the
general population. Little is however known what proportion of this life is spent in different
health statuses as measured by health adjusted life expectancy (HALE) and if this measure
differs across sub populations in Kenya. This longitudinal study set out to achieve five objectives
namely: to assess health related quality of life (HRQOL) of adult HIV/AIDS patients newly
started on HIV care and treatment in Nyanza and Central regions of Kenya; to compare transition
probabilities from baseline health states to health states at one year follow-up for adult
HIV/AIDS patients in Nyanza and Central regions of Kenya; to compare HALE among adult
HIV patients in Nyanza and Central Kenya regions; to determine factors associated with HALE
for adult HIV/AIDS patients in Nyanza and Central regions of Kenya; and to compare HALE
results estimated using Sullivan and multistate life table (MSLT) approaches.
Data were collected in two waves among adult HIV patients aged 15 years and above newly
diagnosed with HIV in six public health facilities in Nyanza and Central regions of Kenya.
Demographics, socio-economic, biomedical and self-reported health related quality of life
(HRQOL) information. Two summary measures of health; physical health summary (PHS)
measure and mental health summary (MHS) measure were obtained from HRQOL measures
which were then categorized into different health thresholds and using both Sullivan and MSLT
approaches, the number of years spent in each threshold (HALE) was obtained.
The findings of the study showed that there were significant differences in health adjusted life
expectancy between Nyanza and Central regions. Life expectancy adjusted for various MHS
statuses was lower than that adjusted for various PHS statuses. The proportion of life spent in
good health status was higher among male than female, was higher among those initially in good
health statuses than those initially in poor health statuses and higher among those in Central than
in Nyanza region. HALE estimates obtained using Sullivan method were higher for proportion of
life spent in poor health statuses compared to estimates obtained using MSLT approach.
The findings of the study clearly demonstrate PLWHA in Kenya spend substantial proportion of
their lives in poor health states and regional differences persist. Different methodological
approaches provide different estimates of health adjusted life expectancy. There is need for
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further studies to explain observed regional differences as well as further comparison of results
obtained using the two approaches since Sullivan approach may have overestimated proportion
of life spent in poor health status due to use of baseline HRQOL estimates.