Psychosocial and structural factors and changes in quality of life measures among people living with HIV in British Columbia, Canada

We examined determinants of quality of life (QoL) at enrollment and over time among people living with HIV(PLWH) aged ≥19 years in British Columbia, Canada, between January 2016-September 2021. The participants completed the surveys at enrollment, 18 and 36 months. QoL was measured using the Short-Form Six-Dimension Scale, social support using the Medical Outcome Study Social Support Survey, and depressive symptoms using the Center for Epidemiologic Studies Depression Scale-10. We used generalized linear mixed modeling to examine the factors associated with QoL at enrollment and changes in QoL scores over time. Among the 644 participants, higher depression scores (<i>β </i>= -0.009, <i>p </i>< 0.001), mental health diagnoses (<i>β</i> = -0.023, <i>p </i>= 0.015), and, counterintuitively, higher satisfaction with physician care (<i>β </i>= -0.002, <i>p </i>= 0.047) were associated with lower QoL scores at enrollment. Higher QoL scores were associated with transgender or non-binary participants (<i>β </i>= 0.044, <i>p </i>= 0.021), Latin American ethnicity (<i>β </i>= 0.081, <i>p </i>< 0.001), income of ≥$30,000 per year (<i>β </i>= 0.044, <i>p </i>< 0.001), and food security (<i>β </i>= 0.043, <i>p </i>< 0.001). Increases in QoL scores over time were associated with lower depression scores in follow-up (<i>β </i>= 0.05863, <i>p </i>= 0.001) and reporting a change from food insecure to food secure (<i>β </i>= 0.0066, <i>p </i>= 0.017). Decreases in QoL scores over time were associated with changes from food secure to food insecure (<i>β </i>= -0.0688, <i>p </i>< 0.001). These results highlight the importance of socio-structural factors and mental health as determinants of QoL in PLWH.