The Impact of Symptoms Multidimensionality, Social Support, and Self-Efficacy on Quality of Life in People Living With HIV Based on the Least Absolute Shrinkage Selection Operator Algorithm: A Cross-Sectional Study in China

Our study aimed to identify the key factors influencing the quality of life (QOL) in people living with HIV (PLWH) and explore the relationships among these variables within the theory of the Self-Regulatory HIV Symptom Management Model. A cross-sectional quantitative design was used, with 568 PLWH participating in an online survey conducted at designated medical institutions in China from November 2021 to January 2022. Our study employed questionnaires to evaluate sociodemographic variables, clinical parameters, symptoms multidimensionality, self-efficacy, social support, and QOL. The least absolute shrinkage selection operator algorithm was used to identify potential key factors. Most participants (73.1%) were male, with a mean age of 39.2 ± 11.7 years. Nearly 87.0% of participants were using antiretroviral therapy, and 43.8% had a CD4 count of ≥ 500 cells/mm3. Additionally, 63.9% reported experiencing symptoms. We found that key factors affecting the QOL of PLWH included race, employment status, family size, disease stage, comorbidities, symptom multidimensionality, number of symptoms, self-efficacy, and social support. Symptom multidimensionality and the number of symptoms were observed to have a negative effect on QOL, with QOL declines as the number of symptoms increases. Conversely, self-efficacy and social support positively influenced QOL, with a stronger impact observed when self-efficacy scores were above 55. Our study highlighted the impact of the symptom multidimensionality on QOL, influenced by individual intrinsic traits and sociocultural factors, providing management approaches from a multidimensional perspective on symptoms.