The interaction network of health-related quality of life in elderly people living with HIV: a cross-sectional study in Chongqing, China.

As antiretroviral therapy has become widely accessible, the number of elderly people living with HIV (PLWH) (≥ 50 years) has risen markedly. Their health-related quality of life (HRQoL) is shaped by intertwined biological, psychological, and social determinants. This study aimed to characterize the interaction structure of these factors using a network approach and to identify potential targets for intervention. We conducted a cross-sectional study including 802 HIV-positive individuals aged 50 years or older in Chongqing, China. A mixed graphical model (MGM) with EBIC selection and LASSO regularization was applied to estimate a network comprising 17 variables. Edges represent regularized partial correlations. Centrality indices were computed, and stability was evaluated via bootstrap procedures (1,000 iterations). Depressive symptoms occupied a central position in the network and showed strong negative connections with both physical and mental health domains. Income level and peer support served as bridging nodes linking different domains. Behavioral clustering, particularly between smoking and alcohol use, was observed. Clinical indicators such as CD4 count and viral load were positioned at the periphery. A depression-centred interaction system governs HRQoL in elderly PLWH. These findings underscore the importance of integrating psychosocial care into routine HIV management.