Correlates of quality of life in people living with HIV infection beyond viral load suppression in Africa: a scoping review

TL;DR

This scoping review explores factors affecting quality of life in HIV-positive individuals in Africa beyond achieving viral load suppression.

Contribution

The study identifies social, economic, and demographic correlates of quality of life in HIV patients in Africa.

Findings

Poor quality of life is linked to HIV-related stigma, lack of family support, and poor living conditions.

Employment and education are positively associated with better quality of life.

Older individuals with HIV report lower quality of life due to health issues and comorbidities.

Abstract

Effective antiretroviral therapy for HIV has allowed people to achieve viral load suppression (VLS), transforming HIV from an acute, life-limiting illness into a chronic condition that is managed effectively with ongoing treatment, reducing it to an undetectable level in the body.

Living with the virus long-term brings new challenges in the management of ongoing treatment and the underlying condition, which may impact quality of life (QoL). However, there is currently no clear evidence regarding factors that promote or predict QoL in this group. This scoping review aimed to identify and synthesise existing literature on the correlates of QoL in patients with HIV and viral load suppressed to identify research gaps and inform future intervention development.

Given the differing healthcare systems internationally and high rates of HIV infection in Africa, the review focused on peer-reviewed research conducted in Africa. ProQuest, PubMed, EBSCO and Sabinet African Journals electronic databases were systematically searched, and 409 studies published between 1 January 2013 and 31 December 2023 were identified for screening. The findings from eight included articles were extracted verbatim for analysis according to four QoL domains: physical, psychological, social and environmental factors.

Poor QoL was associated with increased stigma associated with HIV, lack of family support and poor living conditions, whereas employment and education emerged as correlates of QoL. Demographic factors also influenced QoL, for example, older people with HIV frequently reported low QoL scores, and they were prone to health issues and comorbidities, which had a detrimental influence on their physical and mental health.

Research is required to develop interventions that target medical management and address the social, economic and environmental determinants of QoL among people living with HIV in Africa.

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