Perceived Determinants of Excellent Self-Rated Health Among HIV Virally Suppressed Adults in the Eastern Cape Province, South Africa

The goal of antiretroviral therapy (ART) is to achieve viral suppression and improve the quality of life in people living with HIV (PLWH). Targeting the determinants of self-rated health in virally suppressed PLWH could significantly contribute towards sustaining the quality of life and health gains from ART. A qualitative study was conducted to investigate the determinants of excellent self-rated health in PLWH who are virally suppressed in the Eastern Cape province. A descriptive cross-sectional study using qualitative approach was conducted among 26 consenting adults living with HIV who have achieved viral load suppression in the rural province of the Eastern Cape using in-depth interviews. Themes were generated from the qualitative data using thematic analysis in NVivo 13^®. All participants described what they perceived as excellent quality of life as mostly determined by self-system (downward counterfactual thinking and pain discounting), perceived improved health, and adherence to recommended healthy behaviours (ART, diet, physical activity, and non-use of tobacco and alcohol products). Income/financial support availability and good healthcare access emerged as indispensable prerequisites for achieving and maintaining good health or adherence to healthy behaviours. Targeting the determinants of Self-Rated Health (SRH) has the potential to greatly improve physical and mental well-being of PLWH beyond viral suppression. Interventions can be more effective by drawing from evidence generated from context-based research.