Skip to main content
Download PDF

Evaluation of the health-related quality of life and associated factors in Zimbabwean adults living with HIV: a cross-sectional study

BMC Research Notes volume 16, Article number: 251 (2023) Cite this article

Abstract

Objective

HIV remains a global burden, with the Sub-Saharan Africa (SSA) region reporting the largest number of people living with HIV/AIDS (PLHIV). An exponential improvement in the accessibility and uptake of antiretroviral treatment across SSA has significantly improved outcomes for PLHIV. Hence, HIV care goals have shifted from reducing mortality and morbidity to improving health-related quality of life (HRQoL). This study uses generic and condition-specific HRQoL outcomes to holistically determine the HRQoL of Zimbabwean adult PLHIV and associated factors. HRQoL is a dynamic subject construct that warrants continuous evaluation to provide meaningful feedback to various stakeholders. We enrolled 536 adult PLHIV in Zimbabwe. Collected data were analyzed through descriptive statistics and multivariate binary logistic regression.

Results

Our study shows a high HRQoL perception by Zimbabwean PLHIV. Anxiety, depression, and poor environmental health were widely reported domains influencing HRQoL. Also, being aware of HIV status for over a year, not experiencing an adverse event, being married, having adequate finances and food security and having higher educational status were associated with higher HRQoL. It is essential to integrate mental health care into routine HIV care to improve treatment outcomes and HRQoL. Last, implementing bespoke multisectoral HRQoL-enhancement interventions is paramount.

Peer Review reports

Background

HIV remains a global burden, with the Sub-Saharan Africa (SSA) region reporting the largest number of people living with HIV/AIDS (PLHIV) [1, 2]. Encouragingly, the SSA region has made considerable strides in HIV care, ranging from HIV prevention campaigns to scaling up antiretroviral treatment (ART) [2, 3]. Consequently, there has been an exponential improvement in the accessibility and uptake of ART in primary health settings across the SSA, with resultant significantly improved outcomes for PLHIV [4]. For instance, in 2023, over 95% of Zimbabwean PLHIV attained viral load suppression joining four other countries in Eastern and Southern Africa that have met the UNAIDS 95-95-95 targets [5].In addition, Zimbabwe’s repeal of Sect. 79 in the Criminal Law Code, which criminalized HIV transmission, improves access to HIV care and treatment [6]. However, the World Health Organisation (WHO) acknowledges that viral suppression is not the ultimate care/treatment goal [7]. HIV care goals have shifted from reducing mortality and morbidity to improving health-related quality of life (HRQoL) [7, 8]. HRQoL measures the extent of perceived individual functioning in multiple domains, i.e. physical, social and mental health over time [9, 10]. Evaluation of HRQoL is pivotal to patient-centred HIV care, where therapeutic goals include preventing disease progression, reducing symptom complications, improving skills and modifying the severe psychosocial consequences associated with the disease [8]. Moreover, HRQoL measures can be incorporated into models that inform the economic evaluation of HIV/AIDS treatment services, making them pivotal in resource allocation decisions and policy formulations [4, 11, 12].

It is thus essential to understand the HRQoL and its determinants in PLHIV to develop bespoke interventions. Systematic reviews have shown that age, treatment adherence, depression, social support, employment, and HIV-related stigma are associated with HRQoL in PLHIV [11, 13, 14]. However, methodological differences, including heterogeneity of outcome measures across studies, limit external validity. For instance, generic and disease-specific tools have been previously used in isolation or combination to measure HRQoL in PLHIV [15, 16]. Generic instruments can provide results comparable to the general population and other conditions [17]. Conversely, HIV-specific HRQoL outcomes have expanded content validity and more nuanced psychometric performance in measuring HRQoL in PLHIV [18]. However, few studies have applied generic and condition-specific outcomes to holistically understand the HRQoL of PLHIV, particularly in low-income countries where the HIV burden is enormous [19]. This study used generic and condition-specific HRQoL outcomes to determine the HRQoL of Zimbabwean adult PLHIV and associated factors. HRQoL is a dynamic, subjective construct that warrants continuous evaluation to provide meaningful feedback to various stakeholders (e.g., patients, clinicians, and policymakers). A previous study from a single urban facility in Zimbabwe (n = 257) found high HRQoL among PLHIV in 2015. Even so, Zimbabwe has undergone a massive economic decline over the decades, negatively impacting the HRQoL of both PLHIV and the general population. For example, hyperinflation and chronic public health financing have negatively impacted the public healthcare system. More importantly, COVID-19-induced disruptions to livelihoods and HIV care have impacted the HRQoL of PLHIV, hence the need for this study to inform evidence-based care.

Methods

Study design

Cross-sectional study.

Setting

This study was done at three tertiary-level institutions and six polyclinics (primary healthcare facilities) in Harare, the capital city of Zimbabwe. All study sites have dedicated HIV testing, and treatment facilities, including opportunistic infections, care and sexual and reproductive health services.

Participants

We recruited adult PLHIV ≥ 18 years who were willing and able to provide written consent and could understand either English or Shona (a Zimbabwean native language). Exclusion criteria included mentally unstable adults living with HIV and acutely unwell patients requiring emergency care.

Sampling and sample size calculation

We assumed an equitable HRQoL of PLHIV from a South African sample yielding a mean overall HRQoL of 12.57 (SD 4.65) (µ0) [20]. Our minimum sample size was 525 at β = 0.8, 95% CI and assumed mean overall HRQoL of 12.0 (µ1). We determined our sample size using STATISTICA Version 14. Participants were recruited using a consecutive sampling method.

Instrumentation

We used the WHOQOL-HIV-BREF [21] and Eq. 5D-5 L [22] for disease-specific and generic HRQoL evaluations, respectively. The WHOQOL-HIV-BREF consists of 31 items covering six domains, that is spirituality, environmental health, physical health, psychological health, level of independence, social relationship, religion, and personal beliefs. The scores range from 4 to 20: higher scores suggest better HRQoL [21]. The Eq. 5D-5 L comprises five dimensions, i.e., mobility, self-care, usual activities, pain/discomfort, and anxiety/depression [22]. Scores across the five domains are transformed into a summative utility score. Both outcomes are available in Shona, a Zimbabwean native language and are validated. Participants also completed a socio-demographic questionnaire consisting of variables such as gender, age, employment status and level of education (See Supplementary File 1).

Procedure/ethical considerations

We collected data in April 2022 using the Kobo Collect application installed on Android tablets. We embedded mandatory field codes in the electronic data collection tool to negate missing data. Participants signed the consent forms and were interviewed in a private room.

Data analysis

Descriptive statistics (e.g., means and frequencies) were used to describe participants’ characteristics and responses to the standardised outcome measure Bivariate and multivariate binary logistic regression were used to evaluate factors associated with HRQoL. All tests were done at α = 0.05 using SPSS 27.

Results

Participant characteristics

Most participants were females (60.6%), completed secondary education (75.2%), knew their HIV status for more than a year (86.6%), and had disclosed their HIV status (80.0%). Those on ART (97.8%) had been on treatment for more than a year (84.1%) and were always adherent to ART (89.0%). Further, most participants were non-smokers (91.2%), non-alcohol consumers (74.6%), did not use substances (96.3%), and had not experienced any adverse events in the past month prior to data collection (71.6%) - Table 1.

Table 1 Participant characteristics, N = 536
Full size table

Correlations between main outcome variables

WHOQOLHIV-BREF scores were positively and highly correlated to EQ-5D 5 L utility scores (r = .549, p < .001).

Factors associated with HRQoL

Binary logistic regression

In bivariate analysis, low educational attainment, being widowed/divorced, unemployment, low financial status, food insecurity, previous hospital admission, being diagnosed with HIV for less than a year, and experiencing adverse events in the past month were significantly associated with reduced HRQoL - Table 2.

Table 2 Factors associated with HRQoL – Unadjusted odds ratios
Full size table

Multivariate logistic regression analysis

After adjustment for co-variance, not experiencing an adverse event, being aware of HIV status for more than a year, being currently married, having adequate finances and food security and having higher educational status were associated with higher HRQoL - Table 3.

Table 3 Factors associated with HRQoL – Adjusted odds ratios
Full size table

Discussion

This study evaluated the HRQoL of Zimbabwean PLHIV and associated factors. Overall, our study shows a high HRQoL for PLHIV in Zimbabwe. Anxiety, depression, and poor environmental health were widely reported domains influencing HRQoL. Also, being aware of HIV status for over a year, not experiencing an adverse event, being currently married, having adequate finances and food security and having higher educational status were associated with higher HRQoL. Study participants expressed a higher HRQoL evaluation despite the ongoing socio-economic challenges. These findings are comparable with previous studies conducted in Zimbabwe [19], Zambia and South Africa [23, 24], which yielded these mean EQ-5D VAS utility scores; 0.81 ± 0.30 and 0.88 ± 0.10 and 0.89 ± 0.03, respectively. A high perception of HRQoL could reflect cultural conceptualisation or a manifestation of resilience in PLHIV. Most of the study participants had lived with HIV for over a year and may have developed resilience in living with a chronic condition. Systematic reviews have shown that resilience progressively develops and is associated with improved positive well-being, treatment adherence, and posttraumatic growth in PLHIV [25, 26].

Despite the high HRQoL perception/evaluation, most study participants reported problems in the anxiety/depression dimension and poor environmental health. Systematic reviews and meta-analyses show that depression is two to three times more common in PLHIV than in the general population [27]. Risk factors for poor mental health functioning in PLHIV include challenges coping with a recent HIV diagnosis, adverse external environmental factors (e.g., stigmatisation, poor living conditions), the experience of living with a chronic illness and personal/marital relationships challenges [28,29,30,31]. Therefore, it is essential to integrate mental health care into routine HIV care to improve treatment outcomes [32,33,34]. Routine HRQoL and CMDs assessments using generic and condition-specific outcomes followed by appropriate treatment plans incorporating the multi-disciplinary team approach are paramount [35].

We found individuals in relationships or married to have HRQoL higher than those divorced, widowed, or not in a relationship. Marriage or companionship is an essential source of social support. Social support is an essential buffer to stressful life events; it positively impacts an individual’s physical and mental well-being, performance, creativity and competence and brings resilience when confronting stressful situations [36,37,38]. For example, an Ethiopian systematic review showed that PLHIV with good social support were four times more likely to report higher HRQoL when compared to those without (AOR = 4.01, 95% CI 3.07–5.23) [39]. Our findings further affirm previous evidence on the intertwined relationship between social support, adherence to ART and improvement of the overall HRQoL for PLHIV [40,41,42,43].

Consistent with a previous meta-analysis [44], participants who had lived longer with HIV reported a higher HRQoL. Those recently diagnosed may have been in the bereavement process and had not yet accepted their HIV status, leading to poor mental health functioning [45]. More extended periods of awareness and ART intake can facilitate the growth of effective coping approaches, leading to improved mental health and higher HRQoL [44]. In this study, adhering to ART was predictive of improved HRQoL. Increased ART coverage is associated with reduced morbidity, improved immune functioning and psychological well-being, ultimately increasing the overall perceived HRQoL [44]. Also, HIV care centres in Zimbabwe offer infected individuals free counselling and peer support groups [46]. People with more extended treatment periods may have been subjected to formal and informal psychosocial support, which may have led to better acceptance and adherence to care, thus reducing morbidity and improving HRQoL overall [15, 16, 35, 47].

In this study, financial inadequacy and food insecurity, proxy indicators for financial well-being, were predictive of poor HRQoL. For example, participants with adequate finances were four times more likely to have better HRQoL than those with inadequate finances. Our findings follow a previous systemic review showing the link between HRQoL and financial well-being (R2 = 0.108, p = .04) [11]. The relationship between food security and HIV infection is complex and bidirectional. For instance, food insecurity and HIV infection result in a gradual decline of immunity which may lead to a lower HRQoL [48,49,50]. Further, most Zimbabwean PLHIV incur out-of-pocket medical expenses, shrinking their incomes; the financial pressure negatively affects HRQoL. Therefore, providing social and economic incentives for low-income PLHIV should be considered to improve their HRQoL [51].

Further, the experience of adverse events negatively impacted the HRQoL in PLHIV. Commonly reported adverse events included failing a course, bereavement, and loss of income-generation opportunities. Experiencing an adverse event negatively affects mental and physical health as patients may fear reliving past traumatic experiences [25, 26, 44]. Consequently, the burden may lead to troubling memories, poor mental health functioning, and a lower HRQoL [52, 53]. Last, higher education attainment was associated with improved HRQoL; this is consistent with previous systematic reviews [11, 54]. A higher education facilitates stronger awareness of the disease and a better ability to cope with the challenges of a chronic illness [11, 54,55,56,57]. Conversely, lower education, a proxy indicator of poor financial well-being [56], is associated with poor health-seeking behaviours; this further reinforces the need for social and financial support for poorer PLHIV and their families.

Conclusion

Overall, our study findings show high self-evaluation of HRQoL among Zimbabwean PLHIV. Being aware of HIV status for over a year, not experiencing an adverse event, being currently married, having adequate finances and food security and having higher educational status were associated with higher HRQoL. Also, CMDs were highly prevalent. Consequently, we recommend continually integrating mental health services into routine HIV care. Also, periodic HRQoL evaluation to inform evidence-based care is warranted. Last, there is a need to develop and implement bespoke multisectoral interventions to improve the HRQoL of Zimbabwean PLHIV.

Limitations

There are some limitations to our study. First, applying a facility-based, cross-sectional study may have introduced selection bias, and causality cannot be inferred. Further prospective studies recruiting community indwelling patients are needed to understand the longitudinal changes in HRQoL over time fully. Also, we selected participants non-randomly, which may have introduced selection bias. However, a strength of this study was the recruitment of a large sample and using locally-validated, internal HRQoL measures.

Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. The datasets will be availed onto online repositories once all manuscripts related to the study have been published online.

Abbreviations

PLHIV:

Persons living with HIV

ART:

Antiretroviral Therapy

EQ5D-5L:

The 5 level EuroQOL 5 Dimensions

HAT-QOL:

HIV/AIDS - Targeted Quality of Life

HIV:

Human Immune-deficiency Virus

HRQOL:

Health Related Quality of Life

PLWHIV:

People living with HIV

UNAIDS:

The Joint United Nations Program on HIV/AIDS

WHOQOL-HIV-BREF:

World Health Organization Quality of Life Human Immuno-Deficiency Virus BREF

CMD:

Common Mental Disorder

References

  1. Dwyer-Lindgren L, Cork MA, Sligar A, Steuben KM, Wilson KF, Provost NR, et al. Mapping HIV prevalence in sub-saharan Africa between 2000 and 2017. Nature. 2019;570:189–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Parker E, Judge MA, Macete E, Nhampossa T, Dorward J, Langa DC, et al. HIV infection in Eastern and Southern Africa: highest burden, largest challenges, greatest potential. South Afr J HIV Med. 2021;22:1–8.

    Article  Google Scholar 

  3. Yaya I, Djalogue L, Patassi AA, Landoh DE, Assindo A, Nambiema A, et al. Health-related quality of life among people living with HIV/AIDS in Togo: individuals and contextual effects. BMC Res Notes. 2019;12:140.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Robberstad B, Olsen JA. The health related quality of life of people living with HIV/AIDS in sub-saharan Africa - a literature review and focus group study. Cost Eff Resour Alloc. 2010;8:1–11.

    Article  Google Scholar 

  5. IGO JUNP on H 2023. LCB-N-S 3. The path that ends AIDS: UNAIDS Global AIDS Update 2023. 2023.

  6. UNAIDS. UNAIDS welcomes parliament’s decision to repeal the law that criminalizes HIV transmission in Zimbabwe. 2022.

  7. Lazarus JV, Safreed-Harmon K, Barton SE, Costagliola D, Dedes N, del Amo Valero J, et al. Beyond viral suppression of HIV - the new quality of life frontier. BMC Med. 2016;14:10–4.

    Article  Google Scholar 

  8. Algaralleh A, Altwalbeh D, Al-Tarawneh F. Health-Related Quality of Life among Persons living with HIV/AIDS in Jordan: an exploratory study. HIV AIDS (Auckl). 2020;12:897–907.

    PubMed  Google Scholar 

  9. Nigusso FT, Mavhandu-Mudzusi AH. Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors. Health Qual Life Outcomes. 2021;19:63.

    Article  PubMed  PubMed Central  Google Scholar 

  10. (CDC C for DC. and P. Measuring healthy days: Population assessment of health-related quality of life. 2001.

  11. Degroote S, Vogelaers D, Vandijck DM. What determines health-related quality of life among people living with HIV: an updated review of the literature. Arch Public Heal. 2014;72:1–10.

    Google Scholar 

  12. Mutabazi-Mwesigire D, Katamba A, Martin F, Seeley J, Wu AW. Factors that affect quality of life among people living with HIV attending an urban clinic in Uganda: a cohort study. PLoS ONE. 2015;10:1–21.

    Article  Google Scholar 

  13. Robberstad B, Olsen JA, Ballester-Arnal R, Gil-Llario MD, Castro-Calvo J, Giménez-García C, et al. Association between patient engagement in HIV care and antiretroviral therapy medication adherence: cross-sectional evidence from a regional HIV care center in Kenya. AIDS Care. 2015;27:378–86.

    Article  Google Scholar 

  14. Ballester-Arnal R, Gil-Llario MD, Castro-Calvo J, Giménez-García C. HIV-Risk Index: Development and Validation of a brief risk index for hispanic Young People. AIDS Behav. 2016;20:1796–807.

    Article  PubMed  Google Scholar 

  15. Mûnene E, Ekman B. Association between patient engagement in HIV care and antiretroviral therapy medication adherence: cross-sectional evidence from a regional HIV care center in Kenya. AIDS Care. 2015;27:378–86.

    Article  PubMed  Google Scholar 

  16. Engelhard EAN, Smit C, Van Dijk PR, Kuijper TM, Wermeling PR, Weel AE, et al. Health-related quality of life of people with HIV: an assessment of patient related factors and comparison with other chronic diseases. Aids. 2018;32:103–12.

    Article  PubMed  Google Scholar 

  17. Finch AP, Brazier JE, Mukuria C. What is the evidence for the performance of generic preference-based measures? A systematic overview of reviews. Eur J Heal Econ. 2018;19:557–70.

    Article  Google Scholar 

  18. Meng S-Q, Cheng J-L, Li Y-Y, Yang X-Q, Zheng J-W, Chang X-W, et al. Global prevalence of digital addiction in general population: a systematic review and meta-analysis. Clin Psychol Rev. 2022;92:102128.

    Article  PubMed  Google Scholar 

  19. Mafirakureva N, Dzingirai B, Postma MJ, Hulst M, Van, Khoza S. Health-related quality of life in HIV / AIDS patients on antiretroviral therapy at a tertiary care facility in Zimbabwe. AIDS Care. 2016;28:904–12.

    Article  CAS  PubMed  Google Scholar 

  20. Cronje JH, Williams M, Steenkamp L, Venter D, Elkonin D. The quality of life of HIV-infected south african university students: experiences with the WHOQOL-HIV-Bref. AIDS Care. 2017;29:632–5.

    Article  PubMed  Google Scholar 

  21. Hsiung P-C, Fang C-T, Wu C-H, Sheng W-H, Chen S-C, Wang J-D, et al. Validation of the WHOQOL-HIV BREF among HIV-infected patients in Taiwan. AIDS Care. 2011;23:1035–42.

    Article  PubMed  Google Scholar 

  22. Jelsma J, Mhundwa K, De Weerdt W, De Cock P, Chimera J, Chivaura V. The reliability of the Shona version of the EQ-5D. Cent Afr J Med. 2001;47:8–13.

    CAS  PubMed  Google Scholar 

  23. Thomas R, Burger R, Harper A, Kanema S, Mwenge L, Vanqa N et al. Articles differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial. 2020;5 November 2017:1133–41.

  24. Thomas R, Burger R, Harper A, Kanema S, Mwenge L, Vanqa N, et al. Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial. Lancet Glob Heal. 2017;5:e1133–41.

    Article  Google Scholar 

  25. Dulin AJ, Dale SK, Earnshaw VA, Fava JL, Mugavero MJ, Napravnik S, et al. Resilience and HIV: a review of the definition and study of resilience. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2018;30:6–17.

    Article  Google Scholar 

  26. Pięta M, Rzeszutek M. Posttraumatic growth and well-being among people living with HIV: a systematic review and meta-analysis in recognition of 40 years of HIV/AIDS. Qual Life Res. 2022;31:1269–88.

    Article  PubMed  Google Scholar 

  27. Bernard C, Dabis F, de Rekeneire N. Prevalence and factors associated with depression in people living with HIV in sub-saharan Africa: a systematic review and meta-analysis. PLoS ONE. 2017;12:e0181960.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Khamarko K, Myers JJ, Organization WH. The influence of social support on the lives of HIV-infected individuals in low-and middle-income countries. World Health Organization; 2013.

  29. Tran BX, Ohinmaa A, Nguyen LT. Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients. Health Qual Life Outcomes. 2012;10:132.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Belay YB, Ali EE, Sander B, Gebretekle GB. Health-related quality of life of patients with HIV/AIDS at a tertiary care teaching hospital in Ethiopia. Health Qual Life Outcomes. 2021;19:1–11.

    Article  Google Scholar 

  31. Ahmed A, Saqlain M, Bashir N, Dujaili J, Hashmi F, Mazhar F, et al. Health-related quality of life and its predictors among adults living with HIV/AIDS and receiving antiretroviral therapy in Pakistan. Qual Life Res. 2021;30:1653–64.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Remien RH, Stirratt MJ, Nguyen N, Robbins RN, Pala AN, Mellins CA. Mental health and HIV/AIDS: the need for an integrated response. AIDS. 2019;33.

  33. Hoare J, Sevenoaks T, Mtukushe B, Williams T, Heany S, Phillips N. Global systematic review of common Mental Health Disorders in adults living with HIV. Curr HIV/AIDS Rep. 2021;18:569–80.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Chibanda D, Cowan F, Gibson L, Weiss HA, Lund C. Prevalence and correlates of probable common mental disorders in a population with high prevalence of HIV in Zimbabwe. BMC Psychiatry. 2016;16:1–9.

    Article  Google Scholar 

  35. Yang Y, Thai S, Choi J. An evaluation of quality of life among cambodian adults living with HIV/AIDS and using antiretroviral therapy: a short report. AIDS Care. 2016;28:1546–50.

    Article  PubMed  Google Scholar 

  36. Khademi N, Saeidi S, Zangeneh A, Saeidi F, Choobtashani M. The relationship between life satisfaction and quality of life among people living with HIV/AIDS in Kermanshah-West of Iran. Health Soc Care Community. 2020;28:2218–24.

    Article  PubMed  Google Scholar 

  37. Charkhian A, Fekrazad H, Sajadi H, Rahgozar M, Haji Abdolbaghi M, Maddahi S. Relationship between Health-Related Quality of Life and Social Support in HIV-Infected People in Tehran, Iran. Iran J Public Health. 2014;43:100–6.

    PubMed  PubMed Central  Google Scholar 

  38. Dambi J, Corten L, Chiwaridzo M, Jack H, Jelsma J, Mlambo T. A systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS). Health Qual Life Outcomes. 2018;16:1–19.

    Article  Google Scholar 

  39. Mengistu N, Hareru HE, Shumye S, Yimer S, Sisay D, Kaso AW, et al. Health related quality of life and its association with social support among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis. Health Qual Life Outcomes. 2022;20:77.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Vagiri RV, Meyer JC, Godman B, Gous AGS. Relationship between adherence and health-related quality of life among HIV-patients in South Africa: findings and implications. J AIDS HIV Res. 2018;10:121–32.

    Article  Google Scholar 

  41. Bernays S, Tshuma M, Willis N, Mvududu K, Chikeya A, Mufuka J, et al. Scaling up peer-led community-based differentiated support for adolescents living with HIV: keeping the needs of youth peer supporters in mind to sustain success. J Int AIDS Soc. 2020;23:e25570. Suppl 5 Suppl 5.

    Article  PubMed  PubMed Central  Google Scholar 

  42. den Daas C, van den Berk GEL, Kleene M-JT, de Munnik ES, Lijmer JG, Brinkman K. Health-related quality of life among adult HIV positive patients: assessing comprehensive themes and interrelated associations. Qual life Res an Int J Qual life Asp Treat care Rehabil. 2019;28:2685–94.

    Google Scholar 

  43. Zarova C, Chiwaridzo M, Tadyanemhandu C, Machando D, Dambi JM. The impact of social support on the health-related quality of life of adult patients with tuberculosis in Harare, Zimbabwe: a cross-sectional survey. BMC Res Notes. 2018;11:1–7.

    Article  Google Scholar 

  44. Ghiasvand H, Waye KM, Noroozi M, Harouni GG, Armoon B, Bayani A. Clinical determinants associated with quality of life for people who live with HIV/AIDS: a Meta-analysis. BMC Health Serv Res. 2019;19:768.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Dutra BS, Lédo AP, Lins-Kusterer L, Luz E, Prieto IR, Brites C. Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study. Brazilian J Infect Dis an off Publ Brazilian Soc Infect Dis. 2019;23:211–7.

    Google Scholar 

  46. Mazambara F, Chagwena D, Mudzviti T, Sithole S, Monera-Penduka T, Maponga CC, et al. Utility of HIV support groups in advancing implementation research in resource-limited settings: experiences from an urban-setting HIV support group in Zimbabwe. AIDS Res Ther. 2022;19:7.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Monteiro F, Canavarro MC, Pereira M. Factors associated with quality of life in middle-aged and older patients living with HIV. AIDS Care. 2016;28(Suppl 1):92–8.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Engelhard EAN, Smit C, van Dijk PR, Kuijper TM, Wermeling PR, Weel AE et al (2018) Health-related quality of life of people with HIV: an assessment of patient related factors and comparison with other chronic diseases. AIDS 32:103–112

    Article  PubMed  Google Scholar 

  49. Choi SKY, Fielden S, Globerman J, Koornstra JJJ, Hambly K, Walker G, et al. Food insufficiency, housing and health-related quality of life: results from the positive spaces, healthy places study. AIDS Care. 2015;27:1183–90.

    Article  PubMed  Google Scholar 

  50. Moyo N, Maharaj P, Mambondiani L. Food challenges facing people living with HIV/AIDS in Zimbabwe. Afr J AIDS Res. 2017;16:225–30.

    Article  PubMed  Google Scholar 

  51. Gebremichael DY, Hadush KT, Kebede EM, Zegeye RT, Food, Insecurity. Nutritional status, and factors Associated with Malnutrition among people living with HIV/AIDS attending antiretroviral therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia. Biomed Res Int. 2018;2018:1913534.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Adamson B, El-Sadr W, Dimitrov D, Gamble T, Beauchamp G, Carlson JJ, et al. The cost-effectiveness of Financial incentives for viral suppression: HPTN 065 study. Value Heal J Int Soc Pharmacoeconomics Outcomes Res. 2019;22:194–202.

    Article  Google Scholar 

  53. Passos SMK, de Souza LD. An evaluation of quality of life and its determinants among people living with HIV/AIDS from Southern Brazil. Cad Saude Publica. 2015;31:800–14.

    Article  PubMed  Google Scholar 

  54. de Araújo KMST, Leal MCC, Marques AP, de O, Silva SR, de Aguiar A, Tavares RB. Quality of life evaluation of elderly people with HIV assisted in referral services. Cienc e Saude Coletiva. 2020;25:2009–16.

    Article  Google Scholar 

  55. Liu B, Li W. Association between education level and HIV-associated neurocognitive disorder: a systematic review and meta-analysis. Sex Health. 2020. https://doi.org/10.1071/SH20057.

    Article  PubMed  Google Scholar 

  56. Maleki MR, Derakhshani N, Azami-Aghdash S, Naderi M, Nikoomanesh M. Quality of life of people with HIV/AIDS in Iran: a systematic review and Meta-analysis. Iran J Public Health. 2020;49:1399–410.

    PubMed  PubMed Central  Google Scholar 

  57. Patti F, Pozzilli C, Montanari E, Pappalardo A, Piazza L, Levi A, et al. Effects of education level and employment status on HRQoL in early relapsing-remitting multiple sclerosis. Mult Scler J. 2007;13:783–91.

    Article  CAS  Google Scholar 

  58. Gaspar J, Reis RK, Pereira FMV, de Souza Neves LA, de Castro Castrighini C, Gir E. [Quality of life in women with HIV/AIDS in a municipality in the state of São Paulo]. Rev Esc Enferm USP. 2011;45:230–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would want to acknowledge participants for their invaluable participation especially. The data were collected as part of TOT, GYS, TRM, ARC & PC’s undergraduate thesis, which JMD supervised.

Funding

Not applicable.

Author information

Author notes

  1. Tendai O. Tigirigi and Grace Y. Sithole Joint first authors.

Authors and Affiliations

  1. Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe

    Tendai Orial Tigirigi, Grace Yolanda Sithole, Princess Chakara, Gracious Z. Chirombo, Annamore Rutendo Chiweza, Trish R. Mubayiwa, Sidney Muchemwa & Jermaine M. Dambi

  2. Mental Health Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe

    Dixon Chibanda

Authors
  1. Tendai Orial Tigirigi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Grace Yolanda Sithole
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Princess Chakara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gracious Z. Chirombo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Annamore Rutendo Chiweza
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Trish R. Mubayiwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sidney Muchemwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dixon Chibanda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jermaine M. Dambi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Tendai Orial Tigirigi (TOT) - developed the concept and design of the study, collected the data and drafted the first version of the manuscript. Grace Yolanda Sithole (GYS) - developed the concept and design of the study, collected the data and jointly drafted the first version of the manuscript. Princess Chakara (PC) - developed the concept and design of the study, collected the data and contributed to the editing of the second through fifth versions of the manuscript. Gracious Zvikomborero Chirombo (GZC) - developed the concept and design of the study, collected the data and contributed to the editing of the second through fifth versions of the manuscript. Annamore Rutendo Chiweza (ARC) - developed the concept and design of the study, collected the data and contributed to the editing of the second through fifth versions of the manuscript. Trish Rutendo Mubayiwa (TRM) - developed the concept and design of the study, collected the data and contributed to the editing of the second through fifth versions of the manuscript. Sidney Muchemwa (SM) - critically appraised/peer-reviewed and made substantive contributions to the second to fifth versions of the manuscript in preparation for submission to the journal. SM prepared all prerequisite processes for article submission, submitted the manuscript and is the corresponding author. Dixon Chibanda (DC) – reviewed the statistical analysis and critically appraised/peer-reviewed and made substantive contributions to the third to fifth versions of the manuscript in preparation for submission to the journal. Jermaine M. Dambi (JMD) - developed the concept and design of the study, conducted the data analysis and statistical interpretation and revised the first to fifth versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sidney Muchemwa.

Ethics declarations

Ethics approval and consent to participate

Ethical approval for the study was granted by the University of Zimbabwe and the Joint Research and Ethics Committee for the University of Zimbabwe, Faculty of Medicine and Health Science & Parirenyatwa Group of Hospitals (Ref: JREC/154/2022). Site approval was granted by the City of Harare Director of Health Services. All methods were carried out in accordance with the Joint Research and Ethics Committee guidelines and regulations. Participants were treated as autonomous agents and were requested to sign written consent before enrolment. Written informed consent was obtained from all subjects prior to participation in this study. Randomised participant ID numbers were used to preserve confidentiality. Data and signed informed consent forms were stored securely, only the researchers had access to the information gathered, and participants could voluntarily withdraw from the study without any consequences.

Consent for publication

Not applicable as the manuscript does not contain any data from any individual person.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tigirigi, T.O., Sithole, G.Y., Chakara, P. et al. Evaluation of the health-related quality of life and associated factors in Zimbabwean adults living with HIV: a cross-sectional study. BMC Res Notes 16, 251 (2023). https://doi.org/10.1186/s13104-023-06536-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13104-023-06536-3

Keywords

BMC Research Notes

ISSN: 1756-0500

Contact us