# Exploring the core symptoms and influencing factors of fatigue-related symptom clusters in patients with HIV/AIDS

**Authors:** Dan Xu, Jianghui Zhang, Lan Shen, Haowen Chen, Jia Li

PMC · DOI: 10.3389/fpubh.2026.1727263 · Frontiers in Public Health · 2026-03-03

## TL;DR

This study identifies key fatigue-related symptoms and factors in HIV/AIDS patients, highlighting sleep issues as central for targeted management.

## Contribution

The study identifies gender-specific core symptoms and influencing factors in fatigue-related symptom clusters among HIV/AIDS patients.

## Key findings

- Sleep disturbances and fatigue are prevalent in both male and female HIV/AIDS patients.
- Partner’s HIV status and ART duration significantly influence fatigue-related symptoms.
- Sexual dysfunction and daytime functioning are central in female symptom networks.

## Abstract

To explore the core symptoms and associated factors of fatigue-related symptom clusters in people living with HIV/AIDS during follow-up, with the aim of informing precision-based symptom management strategies.

Fatigue-related symptom clusters in patients with HIV/AIDS were assessed using the Fatigue Self-Assessment Scale, the Pittsburgh Sleep Quality Index, the Sexual Dysfunction Scale, and the Groningen Frailty Indicator. Symptom networks were constructed using R software to identify central symptoms based on network metrics. Univariate analysis and multivariate linear regression were then performed to explore potential factors associated with these core symptoms.

Among male patients living with HIV/AIDS, the three most prevalent symptoms within the fatigue-related symptom cluster were fatigue (86.32%), sleep disturbances (44.63%), and weakness (43.32%). In female patients, the top three symptoms were fatigue (73.04%), sexual dysfunction (72.17%), and sleep disturbances (45.22%). In the symptom network for males, the three nodes with the highest strength centrality were sleep disturbances (D5, rs = 1.61), fatigue severity and type (C1, rs = 1.60), and sleep quality (D1, rs = 1.52). In females, the top three most central symptoms were difficulty achieving orgasm (B4, rs = 2.16), daytime functioning (D7, rs = 1.66), and sexual satisfaction (B5, rs = 1.09). Partner’s HIV status, employment status, number of sexual partners, and duration of ART were identified as significant factors influencing the core symptoms within the fatigue-related symptom cluster (p < 0.05).

In the fatigue-related symptom clusters among people living with HIV/AIDS, the core symptoms shared by both male and female patients namely sleep disturbances and impaired daytime functioning indicate that sleep problems are a central feature of these clusters. Accordingly, sleep issues may be considered a primary target for symptom management in this population. Healthcare professionals should develop targeted interventions based on these core symptoms and their influencing factors to improve the efficiency and precision of symptom management for individuals living with HIV/AIDS.

## Full-text entities

- **Diseases:** impaired daytime functioning (MESH:D003072), sleep disturbances (MESH:D012893), Fatigue (MESH:D005221), Sexual Dysfunction (MESH:D012735), weakness (MESH:D018908), Frailty (MESH:D000073496), HIV (MESH:D015658)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

50 references — full list in the complete paper: https://tomesphere.com/paper/PMC12993931/full.md

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Source: https://tomesphere.com/paper/PMC12993931