Gender disparities in health-related quality of life and its predictors among adults on HAART at public health facilities of southern Ethiopia, 2022: A comparative cross-sectional study

Background Health-Related Quality of Life (HRQoL) has been widely used in the era of Highly Active Antiretroviral Therapy (HAART) to assess the impacts and success, as well as the physical, psychological, and social implications of treatment on people living with HIV/AIDS. Identifying and addressing gender disparities in HRQoL is a critical tool in combatting the AIDS epidemic by 2030. Hence, this study aimed at assessing gender disparities in HRQoL among clients on HAART in southern Ethiopia, in 2022. Methods A facility-based comparative cross-sectional study was carried out from July 1 – October 30, 2022. A total of 1179 clients (590 males and 589 females) were selected randomly. Pre-tested interviewer-administered questionnaires and a data abstraction checklist were used to collect the data. The data were entered into EpiData3.1 and exported to SPPS version 23 for analysis. HRQoL was measured using the World Health Organization's Quality of Life HIV short-form (WHOQOL-HIV BREF) tool. χ2 test was computed to see a significant difference in overall HRQoL across males and females. A multivariable regression model was fitted to identify determinants of HRQoL. The adjusted odds ratios (AOR) with the corresponding 95% confidence intervals (95% CI) were used to report determinants of HRQoL. Statistically significant variables in the final model were declared at p-value < 0.05. Results The overall mean (±SD) score of HRQoL was 11.14(±1.87) in which more than half (55.8%) of the clients had a good HRQoL. There was a significant difference in good HRQoL between males (60.5%) and females (51.1%) (χ2=21.57, p <0.001). Being urban residents (AOR= 1.86, 95% CI; 1.36, 2.54), higher educational level education (AOR=5.31, 95% CI; 2.92, 9.66), and having a current CD4 count of ≥500 cells/mm3 (AOR= 2.26, 95% CI; 1.43, 3.58) were positive predictors of a good HRQoL. On the other hand, the presence of opportunistic infection (AOR=0.67, 95% CI; 0.45, 0.89), and being a hazardous alcohol consumer (AOR = 0.73, 95% CI = 0.53, 0.92) were negative predictors. Conclusion Overall HRQoL was found to be low in the study area, with females having significantly lower scores in the majority of domains and overall HRQoL. Due emphasis should be given to those clients with no formal education and who came from rural areas. HAART service providers, addiction counsellors, and psychiatrists should collaborate in offering education on healthy living behaviours, coping mechanisms, and peer support for hazardous alcohol users.