Beyond antiretroviral treatment: Health-related quality of life of patients receiving antiretroviral treatment at a tertiary hospital in South Africa

Abstract

Antiretroviral therapy (ART) has significantly transformed the management of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), positively impacting the health-related quality of life (HRQoL) and life expectancy of people living with HIV and AIDS (PLWHA). HRQoL is a critical consideration for HIV and AIDS patients as it reflects their overall well-being and treatment outcomes. This study aimed to investigate the HRQoL of PLWHA receiving an ART regimen containing tenofovir, lamivudine, and dolutegravir at a tertiary hospital in Johannesburg, South Africa. This descriptive, quantitative, cross-sectional study included 103 patients who consented in writing to participate. Data was collected using WHOQOL HIV-BREF, socio-demographic, health characteristics, and adherence questionnaires. Participants who reported ‘excellent’ and ‘very good’ on the descriptive rating scale were considered to have optimal adherence (≥95 %). This study's statistical significance was set at p ≤ 0.05. More than half of the participants were male (n = 53; 51.5 %), employed (n = 54; 52.4 %) had an income less than 2000 South African Rands (n = 59; 57.3 %), and reported high levels of adherence over a 7-day (n = 71; 68.9 %) and 4-week (n = 70; 67.9 %) reporting period. Majority of the sample considered their health as ‘good’ (n = 82; 79.6 %) and did not consider themselves ill (n = 85; 82.5 %). This study found that education level, income, health status, and perception of illness significantly (p ≤ 0.05) affected most domains of HRQoL and Overall HRQoL. While adherent (≥95 %) patients indicated superior HRQoL across most dimensions relative to non-adherent (≥95 %) patients, significant disparities in mean scores were exclusively noted only in the psychological domain (p = 0.01). Multivariate linear regression analysis revealed that level of education (Ꞵ = 1.18; p = 0.01), income (Ꞵ = 0.72; p = 0.00), perception of illness (Ꞵ = 1.75; p < 0.001), and health status (Ꞵ = 1.68; p < 0.001) are the predictors of overall HRQoL. Monitoring HRQoL in HIV patients is essential for providing holistic care and improving outcomes. By addressing comorbidities, psychosocial challenges, and unmet needs, healthcare providers can enhance the overall well-being and HRQoL of PLWHA.