Noncommunicable chronic comorbidities, perceived social support, depression, and health-related quality of life among people with HIV: a structural equation modeling study.

BACKGROUND

People with HIV (PWH) face substantial physical and mental health challenges, which translates to poorer health-related quality of life (HRQoL) relative to the general population. Additionally, they have a higher risk of developing the non-communicable chronic comorbidities (NCCs). However, the complex interplay between the risk of NCCs, perceived social support (PSS), depression, and HRQoL among PWH has not yet been adequately elucidated.

OBJECTIVE

This study aimed to explore the impact of NCCs risk on HRQoL among PWH, and to examine the mediating roles of PSS and depression in it.

METHODS

A cross-sectional study was conducted from September to December 2024 using a convenience sample of 2620 PWH recruited from all 7 designated hospitals in Nanjing, Jiangsu Province, China. Multidimensional Scale of Perceived Social Support, Patients' Health Questionnaire Depression Scale-9 item, and Medical Outcomes Study HIV Health Survey were used. Meanwhile, the data about NCCs were derived from the hospital outpatient system records. The structural equation model (SEM) was employed to explore the pathways linking NCCs risk to HRQoL, as well as the mediating roles of PSS and depression.

RESULTS

The median scores for PHS and MHS of PWH were 57.77 and 49.72, respectively. Additionally, 28.24% of PWH had NCCs, and 43.89% were detected with depression. NCCs risk was directly and negatively associated with HRQoL among PWH (β=-0.124, P = 0.003), while PSS and depression significantly mediated the association between NCCs risk and HRQoL, accounting for 3.69% and 36.48% of the total association, respectively. Besides, they acted as sequential mediators in a chain pathway, which explained an additional 9.02% to the total association.

CONCLUSIONS

This study identified both direct and indirect associations between NCCs risk and HRQoL among PWH. These findings can inform to the improvement of HRQoL among PWH and offer insights for refining comprehensive care management strategies.