Which financial, relationship, and mental-health factors are associated with quality of life in older people living with HIV?

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People with HIV who have access to treatment are growing older and living healthier lives than in the past. Although improved health and survival are welcome, the psychological and social consequences of ageing and its implications for quality of life are complex for this group. Understanding how ageing, HIV and quality of life intersect is important for developing effective interventions to improve quality of life.

This cross-sectional questionnaire study recruited 100 people with HIV described as over age 50, with an age range of 50–87 and a mean age of 58, through HIV community organizations and clinics. Participants included men who have sex with men (MSM), and Black African and White heterosexual men and women. The researchers used the WHOQOL-HIV BREF and the Every Day Memory Questionnaire, with additional questions about anxiety and depression to supplement the WHOQOL.

Most participants rated their quality of life positively. Bivariate analysis showed that better quality of life, measured by the total score and most domains, was strongly associated with being a man, being in a relationship, being in paid employment, having a higher income and not receiving benefits. Weaker associations were found with being MSM, having a higher level of education and having been diagnosed after age 40.

In multivariate analysis, not receiving benefits was the variable most consistently associated with better quality of life, as was having a partner. Concerns about everyday memory difficulties and anxiety and depression scores were strong predictors of poorer quality of life.

The cross-sectional design could not establish whether these associations were causal. The authors concluded that concerns about memory difficulties, anxiety and depression, along with gender, ethnicity, financial factors and relationship status, are important contributors to quality of life in this group. They called for further research to clarify the mechanisms through which these factors affect quality of life and to identify possible interventions to improve quality of life for older people living with HIV.