Results from a person-centered national survey in Italy: perspectives on ART switching, treatment satisfaction, mental health and psychological disturbances.

People with HIV (PWH) continue to face major medical and psychological challenges. This national cross-sectional survey conducted in Italy by Infectious Diseases specialists and Community-based Advocacy Groups explored disease awareness and its determinants, ART switching, treatment satisfaction, and mental health. Participants completed the HIV Treatment Satisfaction Questionnaire (HIVTSQs-12), the Pittsburgh Sleep Quality Index (PSQI) and the Patient Health Questionnaire (PHQ-9). A total of 500 PWH (67% males) were enrolled. Over half knew their viral load (54%) or CD4+ count (57%), while 31% of respondents were unaware of both. Three in four had switched ART, mostly on clinician advice (90%). About 50% of respondents reported depressive symptoms, and 31% said these affected their daily activities. Anxiety, moodiness, and sleep disorders were the most prevalent conditions (45%, 37% and 36%, respectively). Lower educational level associated with unawareness of immunovirological status, whereas MSM status and once-daily oral treatment were linked to awareness. These findings reveal the psychological burden and the central role of clinicians in ART decision-making, and highlight the significant impact of anxiety, mood, and sleep disorders in quality of life of PWH, underlining the need for integrated mental health support within HIV care.