Article Text

  1. A.R Hoellein,
  2. J. A. Kendall,
  3. J. F. Wilson,
  4. A. C. Thornton
  1. University of Kentucky, Lexington, KY


Background The CD4+ T helper cell count is critical when managing persons living with HIV (PLWH) as it holds clear ramifications for disease severity and susceptibility to opportunistic infections. One would imagine, therefore, that PLWH are well aware of their own CD4 count. The purpose of this study is to examine variables related to unawareness of own CD4 count to better understand possible additional uninformed or perhaps even harmful behaviors.

Methods Patients presenting at the University of Kentucky HIV Clinic were asked to complete a voluntary, IRB-approved, questionnaire regarding their physical and mental health. Data were analyzed with respect to CD4 awareness by simple means, standard deviations, and multiple regression approaches solving for demographics, HIV risk, medication adherence, and other comorbidities.

Results Of the 123 surveys delivered, 102 (82.9%) were returned. Mean age was 40.6 6 9.1 (22-67). Eighty-five were men (83%) and 17 (17%) were women. There were 82 Caucasians, 15 African Americans, 3 Hispanic/Latinos, and one Asian. Sixty-four respondents (67%) are men who have sex with men (MSM), 13 (14%) report high-risk heterosexual activity (HRH), 4 (4%) have a history of intravenous drug use, 2 (2%) indicate blood exposure, and 13 (13%) do not know their risk factor. Fifty-one (50%) count depression and 29 (28.4%) anxiety as a concomitant diseases. Twenty-eight (29%) do not know their CD4 count. Mean CD4 for those reporting a number is 321. Trends and signficant independent variables in our model associated with not knowing one's CD4 count include a higher likelihood of church attendance (p = .042) and spirituality scores (p = .14), poorer medication adherence (p = .097), higher drug use (p = .047), being a woman (p = .078), and feelings of discrimination (p = .005). There was no correlation with age, education, income, HIV risk, depression, anxiety, or other "don't know " variables.

Conclusions In this sample, nearly one-third of respondents did not know their CD4 count. A possible explanation may lie with the observed association with "faith " variables such as spirituality and church attendance. Alternatively, the highly significant positive responses regarding discrimination may belie some "avoidant " tendencies. Nevertheless, these data suggest that a subgroup of PLWH are in dire need of education or otherwise improved participation in their own disease management.

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