GENDER BASED COMPARATIVE STUDY OF THE QUALITY OF LIFE OF PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (PLHIV) ON ANTIRETROVIRAL THERAPY (ART)

Authors

  • Iqra Hamid Khan
  • Jayasree S Kanathasan
  • Sreemoy Kanti Das
  • Awais Gohar The University of Lahore

Keywords:

Quality of life, HAT-QOL, SF-36, Gender, HIV, ART, Antiretroviral therapy

Abstract

Background: Quality of life of people living with HIV is considered important component of HIV care particularly in settings like Pakistan where treatment access and gender disparities continue to determine the health outcomes despite advancements in treatment regimens. This study aims to compare Health Related-QoL (HR-QOL) among male, female, and transgender individuals living with HIV on ART.

Methods: A cross-sectional study was conducted at the HIV/AIDS treatment center of Mayo Hospital, Lahore, between February and July 2024. A sample of 384 participants (221 males, 151 females, and 12 transgender individuals) was selected using non-probability consecutive sampling. Data were collected using the HIV/AIDS-Targeted Quality of Life (HAT-QOL) and SF-36 surveys. Statistical analysis included Chi-square tests for categorical variables and ANOVA for continuous variables, with significance set at p < 0.05.

Results: Out of 384 participants, 57.55% were male, 39.32% female, and 3.13% transgender. A significant difference in social status was observed across gender groups (p = 0.020). HRQoL domains differed significantly by gender; transgender individuals reported better overall function (76.11 ± 23.78) compared to females (69.47 ± 22.62) and males (74.1± 23.5), p = 0.001. Multivariate regression showed that health worries had the strongest association with HRQoL among transgender individuals (standardized β = 0.567, 95% CI: 0.09–0.30), compared to males (β = 0.432) and females (β = 0.527), emphasizing the differential impact on quality of life.

Conclusion: Gender-specific differences in HRQOL among PLHIV needs considerations for gender-sensitive healthcare approaches to improve overall well-being and quality of life for all individuals living with HIV.

References

1. Ismail SD, Pankrac J, Ndashimye E, Prodger JL, Abrahams MR, Mann JFS, et al. Addressing an HIV cure in LMIC. Retrovirology 2021;18(1):21.

2. Gasparro G, Trevisan S, Kiros ST, Malcontenti C, Trotta M, Barbiero A, et al. UNAIDS 90 90 90 target and retention in care of a cohort of migrants living with HIV in a tertiary referral hospital in Florence, Italy. AIDS Behav 2025;29(5):1642–54.

3. Hussain R. Knowledge and discriminatory attitudes towards HIV/AIDS among the women of reproductive age group of Pakistan using the Multiple Indicator Cluster. Public Health Pract 2024;5:100252.

4. Gholap AD, Khuspe PR, Pardeshi SR, Uddin J, Das U, Hatvate NT, et al. Cardiovascular challenges in the era of antiretroviral therapy for AIDS/HIV: A comprehensive review of research advancements, pathophysiological insights. Atherosclerosis 2024;383:1–12.

5. Lazarus JV, Safreed-Harmon K, Barton SE, Costagliola D, Dedes N, del Amo Valero J, et al. Beyond viral suppression of HIV–the new quality of life frontier. BMC Med 2016;14(1):94.

6. Costa DSJ, Mercieca-Bebber R, Rutherford C, Tait MA, King MT. How is quality of life defined and assessed in published research? Qual Life Res 2021;30(8):2109–21.

7. Chambers LA, Rueda S, Baker DN, Wilson MG, Deutsch R, Raeifar E, et al. Stigma, HIV and health: a qualitative synthesis. BMC Public Health 2015;15(1):848.

8. Lin C, Nguyen DB, Nguyen L, Nguyen TT, Li L, Minh Giang L. Navigating cultural and gender aspects of stigma among women living with HIV in Vietnam. Cult Health Sex 2024;26(3):311–25.

9. Magno L, Silva L. Stigma and discrimination related to gender identity and vulnerability to HIV/AIDS among transgender women: A systematic review. Cad Saude Publica 2019;35(5):e00112718.

10. Bayes-Marin I, Egea-Cortés L, Palacio-Vieira J, Bruguera A, Mesías-Gazmuri J, Llibre JM, et al. Determinants of depressive symptoms in people living with HIV: findings from a population-based study with a gender perspective. Int J Environ Res Public Health 2023;20(4):3687.

11. Naing T, Thavorncharoensap M, Riewpaiboon A, Oo HN, Aung MS. Factors affecting health-related quality of life of HIV-infected key population in Myanmar. AIDS Care 2022;34(8):974–81.

12. Hong C, Ochoa AM, Wilson BDM, Wu ESC, Thomas D, Holloway IW. The associations between HIV stigma and mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV. Qual Life Res 2023;32(6):1693–702.

13. Castro R, De Boni RB, Luz PM, Velasque L, Lopes LV, Medina-Lara A, et al. Health-related quality of life assessment among people living with HIV in Rio de Janeiro, Brazil: a cross-sectional study. Qual Life Res 2019;28(4):1035–45.

14. Herrmann S, McKinnon E, Hyland NB, Lalanne C, Mallal S, Nolan D, et al. HIV-related stigma and physical symptoms have a persistent influence on health-related quality of life in Australians with HIV infection. Health Qual Life Outcomes 2013;11(1):56.

15. Bouman WP, Claes L, Brewin N, Crawford JR, Millet N, Fernandez-Aranda F, et al. Transgender and anxiety: a comparative study between transgender people and the general population. Int J Transgend 2017;18(1):16–26.

16. Khan IH, Kanathasan DJ, Das DS, Khan DS, Arshad S, Jabeen S, Gohar DA, Faraz AA. Assessing burden of HIV and integrating health belief model (HBM) influencing preventive behavior among female sex workers of Bahawalpur, Pakistan. TPM–Testing, Psychometrics, Methodology in Applied Psychology 2025;32(S9):2037–46.

17. Logie CH, Abramovich A, Schott N, Levermore K, Jones N. Navigating stigma, survival, and sex in contexts of social inequity among young transgender women and sexually diverse men in Kingston, Jamaica. Reprod Health Matters 2018;26(54):72–83.

18. Sevelius JM, Patouhas E, Keatley JGW, Johnson MO. Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus. Ann Behav Med 2014;47(1):5–16.

19. Bush J. Factors associated with resilience and sense of coherence in adult transgender persons: identifying predictors to reduce health disparities in a vulnerable population [dissertation]. Orlando (FL): University of Central Florida: 2021; p.212.

20. Farah S, Rizk Y, Azar M. Transgender health in the Middle East region: what do we know so far? A literature review. Transgend Health 2023;8(5):270–6.

21. Gorman K, Shipherd J. Coping, resilience, and social support among transgender and gender diverse individuals experiencing gender-related stress. Psychol Sex Orientat Gend Divers 2022;9(1):37–47.

22. Tebbe E. Factors that drive mental health disparities and promote well-being in transgender and nonbinary people. Nat Rev Psychol 2022;1(12):689–704.

23. Batulan Z, Bhimla A, Higginbotham EJ, editors. Chronic conditions that predominantly impact or affect women differently: substance use disorder. In: Advancing Research on Chronic Conditions in Women. Washington (DC): National Academies Press: 2024; p.231–408.

24. Jamshaid M, Heidari A, Hassan A, Mital D. Bone loss and fractures in post-menopausal women living with HIV: a narrative review. Pathogens 2024;13(9):811.

25. Maskew M, Brennan AT, Westreich D, McNamara L, MacPhail AP, Fox MP. Gender differences in mortality and CD4 count response among virally suppressed HIV-positive patients. J Womens Health 2013;22(2):113–20.

26. Fauk N, Asa G, McLean C. “I was very shocked, I wanted it to be over”: a qualitative exploration of suicidal ideation and attempts among women living with HIV in Indonesia. Int J Environ Res Public Health 2023;21(1):9.

27. Brown M. HIV and aging: double stigma. Curr HIV/AIDS Rep 2021;8(2):72–8.

28. Medicine MBIEG. Diversity, stigma, and social integration among older adults with HIV. J Cross Cult Gerontol 2019;10(2):239–46.

Downloads

Published

2026-01-09

How to Cite

1.
Khan IH, Kanathasan JS, Das SK, Gohar A. GENDER BASED COMPARATIVE STUDY OF THE QUALITY OF LIFE OF PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (PLHIV) ON ANTIRETROVIRAL THERAPY (ART). J Ayub Med Coll Abbottabad [Internet]. 2026 Jan. 9 [cited 2026 Jan. 11];37(3). Available from: https://www.ayubmed.edu.pk/jamc/index.php/jamc/article/view/14600

Issue

Vol. 37 No. 3 (2026): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Copyright (c) 2026 Iqra Hamid Khan, Jayasree S Kanathasan, Sreemoy Kanti Das, Awais Gohar

Creative Commons License

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.