# Perceived quality of life and associated lifestyle practices among older people living with HIV in Uganda. A cross-sectional study

## TL;DR

This study explores how lifestyle factors affect the quality of life of older adults with HIV in Uganda, finding that physical activity and diet play important roles.

## Contribution

The study identifies specific lifestyle practices associated with perceived quality of life among older HIV-positive individuals in Uganda.

## Key findings

- Perceived quality of life improved after ART initiation, with 52% reporting poor QoL before ART and 35% after.
- Being aged 60 or older and lifestyle factors like diet and exercise were significantly associated with poor QoL before and after ART.
- Regular physical activity and dietary habits were linked to better perceived quality of life in older HIV-positive individuals.

## Abstract

Perceived quality of life (QoL) is a critical element for older persons living with HIV-positive diagnosis. The intersection of aging, chronic illness, and the complexities of managing HIV significantly influences their quality of life. This study investigated the relationship between perceived QoL and lifestyle factors among older adults living with HIV in Uganda. This cross-sectional survey was conducted with older adults (above 50 years) living with HIV attending The AIDS Support Organization centres across the major regions in Uganda. Data were cleaned and analyzed using STATA 15, with modified Poisson regression assessing factors associated with perceived quality of life. A total of 440 participants were interviewed. While 52% reported poor perceived quality of life before initiating antiretroviral therapy (ART), this decreased to 35% after ART initiation. This suggests a substantial improvement in the health of older adults living with HIV. Before ART initiation, poor quality of life was significantly associated with being aged 60 years or older (adjusted risk ratio [aRR] 1.17, 95% CI 0.94-1.46), adhering to the Seventh-day Adventist (SDA) faith (aRR 1.89, 95% CI 1.12-3.21), being a casual labourer (aRR 0.62, 95% CI 0.41-0.94), being married (aRR 0.65, 95% CI 0.42-1.01), having one sexual partner (aRR 1.50, 95% CI 1.16-1.93), alcohol consumption (aRR 0.71, 95% CI 0.15-0.85), infrequent fruit consumption (aRR 1.75, 95% CI 0.99-3.09), consuming white meat 1-3 times per week (aRR 1.61, 95% CI 1.23-2.10), engaging in sports 4-7 days per week (aRR 0.25, 95% CI 0.08-0.75), walking 4-7 days per week (aRR 0.79, 95% CI 0.62-1.00), and having diabetes (aRR 1.57, 95% CI 1.13-2.19). After ART initiation, poor quality of life remained significantly associated with being 60 years or older (aRR 1.34, 95% CI 0.98-1.83) and being a salaried employee (aRR 0.38, 95% CI 0.21-0.81). Additionally, frequent white meat consumption (4-7 days per week) (aRR 2.01, 95% CI 1.18-3.42) and moderate sports engagement (1-3 days per week) (aRR 1.94, 95% CI 1.47-2.55) were significantly associated with poorer quality of life after ART initiation. No significant associations were observed with other variables. Perceived quality of life in older persons living with HIV was poorer among those aged over 60 years. The risk of poor QoL was lower among those who eat white meat and participate in sports weekly. Increasing physical activity through regular exercise routines in older adults can help reduce the risk of age-related diseases, improve energy levels, reduce stress, enhance appetite and sleep quality, boost cardiovascular and pulmonary endurance, and enhance overall quality of life.