Alina Poudel, Kiran Paudel, Tara Ballav Adhikari, Samaj Adhikari, Mamta Chhetri, Roman Shrestha
Discover Public Health, November 2025. Abstract
Background: Human Immunodeficiency Virus (HIV) is a significant global health challenge that impacts the quality of life (QoL) of people living with HIV and AIDS (PLWHA) worldwide, including Nepal. QoL reflects overall well-being and is essential in HIV care, especially with antiretroviral therapy (ART). Method: We conducted a hospital-based cross-sectional study between December 2023 and January 2024 at the ART clinic of Lumbini Provincial Hospital, involving 246 PLWHA undergoing ART. The hospital was selected purposively and patients were recruited using a non-probability convenience sampling technique. QoL was assessed using the World Health Organization Quality of Life HIV BREF questionnaire (WHOQOL-HIV BREF), which consists of 31 items, with 29 items covering six domains rated on a five-point Likert scale. Domain scores ranged from 4 to 20, with higher score denoting a higher QoL. Data was entered in EpiData version 3.1 and analyzed in SPSS version 20 using descriptive and inferential statistics. Ethical approval was obtained from Institutional Review Committee of Chitwan Medical College and Lumbini Provincial Hospital, and written informed consent from all the participants. Result: A total of 246 patients were enrolled in the study with a median (IQR) age of 45(18) years. More than half of participants were female, married and belonged to Hindu religion, whereas nearly half belonged to Janajati ethnic groups. QoL was higher in the domains of physical health, level of independence and social relationship with a median score of 12(3), 12(2) and 12(3). Conversely, QoL were markedly lower in spiritual health with a median score of 10(4). Age, marital status, education, living status, occupation, regular intake of medicines and co-morbidity significantly influenced the QoL scores. Conclusion: This study highlights significant differences in QoL domains among PLWHA, particularly noting lower spiritual and psychological health scores. These findings suggest a need for targeted psycho-social interventions to improve psychological well-being, social functioning and spiritual health by addressing emotional, social, and spiritual needs.