Factors associated with quality of life among people living with HIV/AIDS in Bamako, Mali: a cross-sectional study

Quality of life is an important outcome of HIV care, particularly in resource-constrained settings. We assessed quality-of-life and its factors associated among people living with HIV(PLHIV) receiving care in Bamako, Mali. We conducted a cross-sectional study among 722 PLHIV receiving care in nine HIV treatment sites from January to September 2023. Sociodemographic, clinical, therapeutic, and laboratory data were collected, and quality-of-life was assessed using the World Health Organization Quality of Life HIV Brief instrument (WHOQOL-HIV-BREF). Six separate multivariable linear regression models were fitted for overall quality of life, health perception, and the four assessed domains. HC3 heteroskedasticity-robust standard errors were used, and the Benjamini-Hochberg procedure was applied globally across coefficient tests to control the false discovery rate. Participants had a mean age of 41.0 years (SD = 11.9), and 78% were women. Mean scores was 2.6 (SD 1.2) for overall QoL, and 3.2 (SD 1.1) for health perception. Mean domain scores were 15.7 (SD 3.0) for physical health, 12.3 (SD 3.5) for psychological health, 12.9 (SD 3.6) for social relationships, and 11.7 (SD 2.9) for environment. Clinical symptoms were consistently associated with lower scores across all six outcomes, with highest difference observed in the physical-health domain (ϐ -2.61, 95% robust CI -3.13 to -2.10). Lower income, lack of formal education, marital status, underweight, older, ART interruption, and care site were associated with selected QoL outcomes after false discovery rate correction. HIV care should extend beyond virological outcomes to address the clinical, socioeconomic, and psychological circumstances shaping quality-of-life. Integrating mental-health care, symptom management, nutritional and social support, and interventions promoting sustained antiretroviral therapy use into routine HIV service could improve the well-being of PLHIV in Bamako.