Examining the Intersection of Quality of Life, Viral Suppression, and Race/Ethnicity Among Women with HIV

OBJECTIVES: Quality of life (QOL), which encompasses mental and physical health and socioeconomic stability, is an important determinant of health outcomes. This analysis assessed the relationship between QOL and viral suppression among women with HIV (WWH) in the Women's Interagency HIV Study and differences across race/ethnicity. DESIGN: A multi-center, prospective, observational cohort study of women living in the U.S. METHODS: Longitudinal data over a 5 year period were used to fit generalized mixed effects regression models to assess the relationship between self-reported QOL (single-item; scale of 0-10) and viral suppression (<200 copies per ml). An interaction term was included to examine a moderating effect by race/ethnicity. Models included sociodemographic, substance use, and health behavior factors. RESULTS: In the cohort sample (n=1,324), on average, the participants were 48 years old (SD = 9.2) and living with HIV while in the study for 16 years. Approximately 90% identified as heterosexual; 70% as Black/African American, 16% as Hispanic, and 11% as White. Roughly 20% of the cohort was not virally suppressed. QOL was positively associated with viral suppression (adjusted odds ratio (aOR)=1.10, 95% CI: 1.04, 1.16). However, the magnitude of this association varied by race/ethnicity, with the highest association among White WWH (aOR=1.36, 95% CI: 1.10, 1.63) and lowest among Black WWH (aOR= 1.08, 95% CI: 1.02, 1.15). CONCLUSION: These findings highlight a positive association between QOL and viral suppression and a moderating effect by race. Future research should assess which specific QOL domains are driving this association to inform tailored interventions.