Health-Related Quality of Life among Children Living with HIV: Self-Reported and Parent Proxy Perspectives from Southern India

Background: Health-Related Quality of Life (HRQoL) is a critical indicator of well-being among children living with HIV. This study assessed HRQoL and explored associated sociodemographic and clinical factors among HIV-infected children in the Belagavi district of Karnataka. Methods: The study employed a cross-sectional design involving 191 HIV infected children aged 8 to 18 years and their parent proxy reports in the ART centers of Belagavi district . HRQoL was assessed using the validated QOL-CHAI instrument, which has been validated for use among Indian children living with HIV. Statistical analyses included non-parametric tests, bivariate associations, and multivariable linear regression analyses to identify predictors of HRQoL. Results: The children indicated elevated HRQoL in physical, emotional, social, and academic domains, signifying minimal discrimination (score of 98.6 ± 5.7) and a low symptom burden (score of 93.5 ± 7.5). Parents reported higher HRQoL in physical and social domains, while children reported higher overall HRQoL. HRQoL was higher among children cared for by their biological mother than by guardians. CD4 count was the only independently associated factor of overall HRQoL in multivariable analysis (β = 0.170, p = 0.026). Caregiving arrangement was significantly associated with HRQoL (p = 0.014). Conclusion: Children Living with HIV (CLHIV) and parents reported a higher HRQoL across different domains, along with comparably high parent proxy scores. In this study, caregiving stability, immune status, and psychosocial well-being emerged as key determinants of perceived quality of life in a resource-limited setting.