Beyond viral suppression: determinants of health-related quality of life in a national HIV cohort in Turkiye

This multicentre study evaluated Health-related Quality of Life (HRQoL) and identified sociodemographic and clinical determinants of physical and mental health outcomes in a large national HIV cohort in Turkiye. This cross-sectional study included 1303 adults across 23 centres. HRQoL was assessed using the Turkish MOS-HIV Health Survey, yielding Physical Health Summary (PHSS) and Mental Health Summary (MHSS) scores. HRQoL scores were dichotomised into “higher” (>50) and “lower” (≤50) groups. Data were analysed via univariate tests and multivariable logistic regression. Participants (88.6% male; median age: 38) were primarily single, employed, and university graduates. The median CD4+ T-cell count and HIV RNA level were 627 cells/mm3 and <50 copy/mL, respectively. Median PHSS and MHSS were 57.25 and 50.57, respectively. While social/role functioning scored highest, health transition scored lowest. Lower PHSS was identified in 22.7% of participants, whereas 47.9% reported lower MHSS. Low education and high daily pill burden significantly increased the risk of lower HRQoL. Interestingly, lower income was independently associated with better HRQoL, while older age and psychiatric treatment correlated with better MHSS. Despite robust physical HRQoL, mental health remains a significant challenge. To achieve “Fourth 90” targets, interventions should prioritise health literacy and integrated mental health services within HIV care.​​Abbreviations: ART: antiretroviral therapy; CF: cognitive functioning; CI: confidence interval; EF: energy/fatigue; GH: general health perception; HAART: highly active antiretroviral therapy; HD: health distress; HIV: human immunodeficiency virus; HL: Hosmer–Lemeshow; HRQoL: health-related quality of life; HT: health transition; MHS: mental health summary; MHSS: mental health summary score; MOS-HIV: medical outcomes study HIV health survey; OR: odds ratio; P: pain; PF: physical functioning; PHS: physical health summary; PHSS: physical health summary score; PLWH: people living with HIV; QL: quality of life; RF: role function; RNA: ribonucleic acid; SF: social function; UNAIDS: joint United Nations programme on HIV/AIDS

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Journal
AIDS Care
Published
2026-07-23
DOI
https://doi.org/10.1080/09540121.2026.2697987
Primary Topic
HIV/AIDS Research and Interventions
Type
article
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article

Beyond viral suppression: determinants of health-related quality of life in a national HIV cohort in Turkiye

Mine Filiz, Turhan Togan, Damla Ertürk, Erdoğan Asar et al.
AIDS Care
HIV/AIDS Research and Interventions
article

Beyond viral suppression: determinants of health-related quality of life in a national HIV cohort in Turkiye

Mine Filiz, Turhan Togan, Damla Ertürk, Erdoğan Asar, Ezgi Gülten, Günay Tuncer Ertem, Hiroyuki Konya, Veysel Akça, Zehra Karacaer, Mehmet Çabalak, Mehmet Serhat Birengel, Fatma Eser, Şerife Barçın Öztürk, Gizem Karahan, Burak Sarıkaya, Seçil Deniz, Deniz Özer, Nazan Tuna, Bircan Kayaaslan, Nuran Sarı, Gülden Eser Karlıdağ, Esra Erdem Kıvrak, Nefise Öztoprak, Gülşen İskender, Gülden Yılmaz, Aliye Baştuğ, Nevin İnce, Mustafa Usanmaz, Özgür Günal, Sevgi Sökülmez Yıldırım, Güle Çınar, Aysun Yalçı, Derya Seyman, Nesibe Korkmaz, Yeşim Taşova, Dilek Bulut, Tuba Damar Çakırca, Aybegüm Özşahin, Merve Bozdağ, Figen Sarıgül Yıldırım, İlknur Esen Yıldız, Selen Şahin, Elif Dilan Dag, Mustafa Erdi Isikci, Ertugrul Yazici
article en

Abstract

This multicentre study evaluated Health-related Quality of Life (HRQoL) and identified sociodemographic and clinical determinants of physical and mental health outcomes in a large national HIV cohort in Turkiye. This cross-sectional study included 1303 adults across 23 centres. HRQoL was assessed using the Turkish MOS-HIV Health Survey, yielding Physical Health Summary (PHSS) and Mental Health Summary (MHSS) scores. HRQoL scores were dichotomised into “higher” (>50) and “lower” (≤50) groups. Data were analysed via univariate tests and multivariable logistic regression. Participants (88.6% male; median age: 38) were primarily single, employed, and university graduates. The median CD4+ T-cell count and HIV RNA level were 627 cells/mm3 and <50 copy/mL, respectively. Median PHSS and MHSS were 57.25 and 50.57, respectively. While social/role functioning scored highest, health transition scored lowest. Lower PHSS was identified in 22.7% of participants, whereas 47.9% reported lower MHSS. Low education and high daily pill burden significantly increased the risk of lower HRQoL. Interestingly, lower income was independently associated with better HRQoL, while older age and psychiatric treatment correlated with better MHSS. Despite robust physical HRQoL, mental health remains a significant challenge. To achieve “Fourth 90” targets, interventions should prioritise health literacy and integrated mental health services within HIV care.​​Abbreviations: ART: antiretroviral therapy; CF: cognitive functioning; CI: confidence interval; EF: energy/fatigue; GH: general health perception; HAART: highly active antiretroviral therapy; HD: health distress; HIV: human immunodeficiency virus; HL: Hosmer–Lemeshow; HRQoL: health-related quality of life; HT: health transition; MHS: mental health summary; MHSS: mental health summary score; MOS-HIV: medical outcomes study HIV health survey; OR: odds ratio; P: pain; PF: physical functioning; PHS: physical health summary; PHSS: physical health summary score; PLWH: people living with HIV; QL: quality of life; RF: role function; RNA: ribonucleic acid; SF: social function; UNAIDS: joint United Nations programme on HIV/AIDS

AIDS Care
Tekirdağ Namık Kemal University (TR), Ankara University (TR), Recep Tayyip Erdoğan University (TR), Manisa Celal Bayar University (TR), Bilkent University (TR), University of Health Science (KH), Başkent University (TR), State Hospital (GB), Gülhane Askerî Tıp Akademisi (TR), Uni Research (Norway) (NO), Ankara Onkoloji Eğitim ve Araştırma Hastanesi (TR), Antalya Eğitim ve Araştırma Hastanesi (TR), Samsun University (TR), Başkent University Hospital (TR), Sağlık Bilimleri Üniversitesi (TR), Gaziosmanpaşa Taksim Eğitim ve Araştırma Hastanesi (TR), Antalya IVF (TR), University of Health Sciences (SO), Ankara Bilkent City Hospital (TR), Pamukkale University (TR), Düzce Üniversitesi (TR), Cukurova University (TR), Adnan Menderes University (TR), Muğla University (TR), Harran University (TR), University of Health Sciences Antigua (AG)
Openalex Percentile: Top 9%
HIV/AIDS Research and Interventions
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