NiVEst study: Dimensions of stigma and quality of life in people living with HIV

Objective: Stigma in people living with HIV (PLHIV) has been found to be negatively associated with quality of life. The study aims to determine whether there are relationships between different dimensions of stigma and quality of life. The secondary objective is to determine associations of stigma with medical variables and to incorporate the use of specific interventions and tools to improve consultation and care for PLHIV. Methods : Cross-sectional, multicentre study involving 144 people living with HIV (PLHIV) on antiretroviral therapy (ART) and prolonged viral suppression. Sociodemographic data were collected through questionnaires, together with the results of the stigma scale adapted to the Spanish population, the quality of life (QoL) scale for people with HIV and clinical data obtained from electronic medical records (EMR). Results : Stigma is negatively associated with QoL (adjusted beta = -0.59 [-0.81; -0.37] p<0.001.There is a negative association between all the subdomains of stigma and overall quality of life, as well as a negative association between all the subdomains of QoL and overall stigma. Total QoL and external perceived stigma have the strongest association (ρ=-0.52, p<0.01) and the stigma related to disclosure concerns and spiritual QoL (p=-0.46 p < 0.001). Total stigma was found to be increased related to lower income (β =-10.30 [-18.40, -2.20], p=0.013), female sex (β =9.64 [1.60, 17.68], p=0.019) and Kaposi's sarcoma (KS) (n=3) during evolution was associated with increased total stigma (β =23.57 [7.26, 39.88], p=0.007) and externalised stigma (β =14.76 [6.12, 23.4], p=0.002). Conclusions : Stigma and quality of life in people living with HIV (PLHIV) are closely related. Our study demonstrates that greater stigma is associated with lower quality of life, particularly in spiritual well-being. The subdomains of both stigma and quality of life show a significant negative relationship. Moreover, higher-risk groups, such as women, individuals with low incomes, or patients with advanced disease, are more vulnerable to stigma, which worsens their quality of life and increases the risk of adverse disease progression. It is crucial to adopt a holistic approach that includes both medical treatment and psychosocial support to improve long-term well-being and quality of life.