Patient-reported quality of life in people living with HIV in Romania: a cross-sectional PROM-based study

BACKGROUND: In Romania, people living with HIV represent heterogeneous cohorts shaped by distinct epidemiological and social contexts. While antiretroviral therapy (ART) has markedly improved survival, quality-of-life (QoL) encompasses broader dimensions not fully captured by clinical indicators. Patient-reported outcome measures (PROMs) offer a valuable approach to understanding these dimensions in routine care. METHODS: We conducted a multicenter, cross-sectional study using the OCTAVE PROM to assess patient-reported health-related QoL among people with HIV in Romania. The self-completed questionnaire evaluates eight domains: ART, physical health, mental health, sleep quality, sexuality, emotional wellbeing, non-HIV-related health, social and professional life. Adults attending routine follow-up visits in HIV centers across Romania were consecutively enrolled between August 2024 and July 2025. RESULTS: < 0.001). Higher education was linked to better self-perceived physical functioning, emotional wellbeing, social integration, and financial security. CONCLUSIONS: This large, multicenter PROM-based study demonstrates that while treatment-related QoL among people with HIV in Romania is high, challenges persist in sexuality, sleep, and social wellbeing. Educational level emerged as key determinant of patient-reported outcomes. Integrating PROMs into routine HIV care can enhance patient-centered approaches by identifying unmet needs beyond virological control and informing targeted, individualized interventions.