Provider, researcher, and community perspectives on comorbidities affecting the health-related quality of life of people living with HIV in Spain

Comorbidities, such as cardiovascular disease, diabetes, kidney disease, liver disease, and mental health issues, negatively impact the health-related quality of life (HRQoL) of people living with HIV (PLHIV). Comorbidities can increase the symptom burden, reduce functional or cognitive capacity, increase psychological distress, and reduce adherence to treatment, which can lead to poor viral suppression and other complications. This study aimed to identify and explore comorbidities and related contextual determinants of HRQoL and long-term well-being in PLHIV that could be monitored in routine care in Spain. Seven online focus groups were conducted with 115 participants consisting of members of community advocacy organizations (n = 33, 29%), HIV care providers (n = 78, 68%) and researchers (n = 4, 3%) in seven autonomous communities in Spain with the highest incidence of HIV. Focus group results revealed a prioritised list of comorbidities to monitor: diabetes, cardiovascular diseases, neurologic diseases, substance use problems, bone diseases, renal diseases, liver diseases, including metabolic dysfunction-associated steatotic liver disease, cancers and neoplasms, mental health problems, and pulmonary diseases. This study emphasises the impact of comorbidities on PLHIV in Spain and the need for a comprehensive approach to HIV care that addresses comorbidities, including mental health. These data can inform the development of policies and interventions to reduce multimorbidity burden among PLHIV.