Exploring determinants of quality of life for virally suppressed people with HIV in Northern Taiwan

TL;DR

This study identifies factors affecting quality of life in HIV-positive individuals in Taiwan, emphasizing mental health and socioeconomic status.

Contribution

The study identifies depressive symptoms, income, education, and relationship status as key determinants of quality of life in virally suppressed HIV patients.

Findings

Depressive symptoms were the strongest factor linked to lower quality of life across all domains.

Higher income and education were associated with better quality of life.

Being married or in a romantic relationship improved psychological and social well-being.

Abstract

With the success of antiretroviral therapy (ART), quality of life (QoL) has become a central goal in HIV care under the “Fourth 90” framework. While Taiwan has made significant strides in achieving UNAIDS targets, QoL among people with HIV (PWH) remains an ongoing challenge. This study explored determinants of QoL among virally suppressed PWH in Taiwan.

A cross-sectional study was conducted a major HIV clinic in Taipei, enrolling 767 virally suppressed PWH between December 2018 and June 2021. Viral suppression was defined as an HIV RNA level of < 40 copies/mL, quantified using a standardized RT-PCR assay, measured within 6 months prior to enrollment. QoL was assessed using the World Health Organization Quality of Life Scale – brief version (WHOQOL-BREF), depressive symptoms using the validated Center for Epidemiologic Studies Depression Scale (CES-D), and medication adherence using the Medication Adherence Report Scale (MARS-5). Sociodemographic and clinical characteristics were collected through structured interviews. Multivariable linear regression analyses were performed to identify factors associated with QoL domains.

Overall, 78.5% of participants reported good self-perceived QoL. Depressive symptoms were the strongest factor associated with lower QoL across all four domains (physical, psychological, social, and environmental), with reductions of approximately 2–3 points per domain. Higher income and educational attainment were associated with better QoL. Marriage and having a romantic partner were associated with higher psychological and social well-being.

Among virally suppressed PWH in Taiwan, depressive symptoms, socioeconomic factors, and relationship status were strongly associated with QoL. These findings support the integration of routine depression screening, financial aid expansion, education-related support, and inclusive relationship policies into HIV care to advance the Fourth 90 goal of optimizing quality of life.

Not applicable.