OBJECTIVES:

Virally suppressed people living with HIV (PLHIV) report significantly lower health-related quality of life (HRQL) than the general US population. A sequential quantitative-qualitative study design was conducted to further understand current unmet needs and HRQL for PLHIV in the U.S.

METHODS:

This study involved a cross-sectional survey, conducted with a representative sample of PLHIV in the US (N=1,226), which included the Functional Assessment of HIV Infection (FAHI), where higher scores indicate better HRQL. Following the survey study, three focus-groups were conducted with PLHIV (N=22) to further explore the quantitative findings, and possible solutions for improving HRQL among PLHIV.

RESULTS:

The FAHI mean (SD) total score for the overall sample was 113.4/176 (32.0), with mean (SD) domain scores for cognitive functioning 7.5/12 (3.0), social well-being 18.1/32 (8.0), emotional well-being 26.0/40 (9.2), physical well-being 29.1/40 (8.5), functional and global well-being 32.7/52 (10.8). Emotional well-being was significantly higher among older (age ≥50) survey participants compared to younger participants (age<50) (difference score: 3.0; p<0.005). The FAHI total score and other domain scores were comparable by age group. PLHIV residing in metropolitan statistical areas (MSAs) reported better physical, emotional, functional and global well-being than PLHIV in non-MSAs (p<0.005 for all domains). Focus-group participants described the emotional (e.g., depression, anxiety and overwhelm), physical, and social (particularly around dating and stigma) impacts of living with HIV. Possible solutions for addressing unmet needs for PLHIV emerged from the focus group discussions, including increasing availability of emotional support programs, low-income housing, quality healthcare and HIV tailored medical advice (especially in rural areas).

CONCLUSION:

Life expectancy for PLHIV has improved significantly, yet PLHIV still experience significantly reduced HRQL. The results of this study confirm there are still unmet needs which impact HRQL among PLHIV in the US and identified specific areas for focus and possible solutions from the patient-perspective.