From health to AIDS: exploring the quality of life among men who have sex with men along the HIV spectrum in a mid-sized city in Indonesia

Health-related quality of life (HRQoL) is an important indicator for people living with HIV/AIDS (PLHA). However, data on HRQoL among men who have sex with men (MSM) in Indonesia remains limited. This study aimed to measure HRQoL among MSM individuals based on their status. This cross-sectional study involved 152 MSM participants. We measured HRQoL using the EQ-5D-5L instrument and compared utility scores among HIV-negative, HIV-positive, and AIDS groups. Results showed a significant and substantial decline in HRQoL with the progression of HIV status, with the AIDS group having the lowest utility score (0.416) compared to the HIV-positive (0.908) and HIV-negative (0.981) groups. However, there was no significant difference between the HIV-negative and HIV-positive groups. In the multivariate analysis, socio-demographic factors were not significant in predicting HRQoL, while all EQ-5D-5L domains were significant predictors. In conclusion, while current interventions are effective in maintaining physical function, the primary burden on HRQoL shifts to pain and psychological issues. This finding underscores the need for a holistic public health approach that integrates mental health services and social support into HIV care.