Determinants of quality of life in people living with HIV and changes over time: cross-sectional and longitudinal clinic-based assessments using the WHO-QoL-HIV-BREF in Antwerp, Belgium 2016–2023

With HIV evolving into a chronic disease, attention is shifting to quality of life (QoL) of people living with HIV (PLWH). We analyzed monitoring data on QoL of PLWH followed up at the Antwerp HIV clinic between 2016-2023, using the WHO-QOL-HIV BREF. Using logistic regression, we analyzed associations of QoL after adjusting for covariates. Changes in QoL across repeated measurements were calculated for a standardized period (mean change score per year). We used data from 1068 PLWH at baseline and 470 at follow-up. Overall, 76.0% had a good QoL, but people with a non-European background scored significantly lower. After controlling for covariates, acceptance of HIV status, place of birth, sexual orientation, relationship status, and subjective health were associated with QoL. Longitudinal analyses revealed no significant improvement in QoL over time. In this study, PLWH scored below a potential target of 90% with good QoL. Specific interventions are needed to improve the QoL of PLWH and should focus on mental health, sexual well-being, and sleep quality. Acceptance of HIV status was the strongest determinant of QoL and may indicate promising intervention avenues. PLWH with a migrant background may benefit from a tailored approach, particularly in the environmental domain.