Psychosocial syndemics and quality of life among Australian people living with HIV.

Objective: Advances in treatment have transformed HIV into a manageable chronic illness, yet people living with HIV (PLHIV) continue to face psychosocial challenges that reduce quality of life (QoL). These factors often co-occur and interact, creating syndemic effects that worsen outcomes. Method: This study examined relationships between HIV-related stigma, mental health difficulties, and social disconnection in predicting QoL. Participants were 213 PLHIV (184 male, 21 female, eight transgender/other/undisclosed) attending Albion, an urban tertiary HIV clinic in Sydney, Australia. They completed questionnaires assessing stigma, mental health, social support, and QoL. Results: HIV-related stigma, mental health difficulties, and social disconnection each independently predicted poorer QoL. A syndemic effect was found between stigma and social disconnection, with QoL lowest when both were high. Conclusions: Psychosocial comorbidities significantly impact QoL in PLHIV. Findings underscore the value of a syndemic framework to guide clinical research and highlight the need for holistic interventions addressing stigma, social support, and mental health.