The rural-urban disparity in the quality of life among people living with HIV under different household structures in China: a cross-sectional study

To explore the association between household structures and the quality of life (QOL) in people living with HIV (PLWH) in rural and urban regions in China. A cross-sectional descriptive design was employed in this multicenter study. 711 people living with HIV (PLWH) from nine provinces or municipalities with different incidence levels in China were investigated through questionnaires. The QOL level, sociodemographic, and clinical characteristics were collected by the WHOQOL-HIV BREF and the sample characteristics checklist. Multivariable linear regression was used to explore the association. 711 PLWH completed the survey. PLWH living only with oneself compared with other groups reported the highest QOL (89.14 ± 18.42 versus 85.45 ± 15.81 versus 82.62 ± 14.22 versus 82.53 ± 14.20), and similar results were presented in the sub-domains analysis. Rural residents exhibited a stronger inverse association between household size and QOL (β = – 3.89, 95% CI: – 6.03 to – 1.75; P = 0.0004) compared to urban counterparts (β = – 1.55, 95% CI: – 2.97 to – 0.14; P = 0.032). This study demonstrates that the number of inhabitants has a negative association with QOL among PLWH in China and further reveals significant urban-rural disparities in how household environments influence the QOL among PLWH. This finding will encourage healthcare providers, social workers, case managers, and other relevant professionals to focus on assessing household size and other relevant factors when providing care to PLWH. Clinicaltrials.gov: ChiCTR2100046225. Registered 11 May 2021.