Quality of life in people living with HIV (the fourth 90)–are we there yet in Australia?

Daniel Yan, James McMahon, Sue Lee, Michelle L. Giles

Research output: Contribution to journalArticleResearchpeer-review


In 2014, UNAIDS outlined the 90-90-90 treatment targets. The “fourth 90” reflects the need to focus on optimising quality of life (HRQoL) in people living with HIV. Using a sample of non-heterosexual males in Melbourne, Australia, we aimed to assess HRQoL differences between HIV-positive and HIV-negative individuals, and identify factors that predict HRQoL both at baseline and after three years of follow up. Clinical information and patient-reported outcomes incorporating the Assessing Quality of Life-6D scale were collected at baseline and at three years. Sixty-two HIV-positive cases (antiretroviral therapy naïve at baseline) and 48 controls were enrolled. Results were compared between cases and controls at baseline, three-year follow-up, and between timepoints. HRQoL was significantly lower in cases compared to controls (83.5 (IQR 77.2–88.6) vs 87.3 (IQR 82.1–91.8), p = 0.022) at baseline, with increased depression and anxiety associated with reduced HRQoL in multivariate analysis. Mental health in cases improved between timepoints (75.0 (IQR 56.3–81.3) to 81.3 (IQR 62.5–81.3), p = 0.0428). No differences between the HRQoL of cases and controls were observed at three years. Increased mental health support may be required at commencement of antiretroviral therapy to enable similar levels of HRQoL between HIV-positive and HIV-negative individuals to be achieved.

Original languageEnglish
Pages (from-to)306-315
Number of pages9
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number2
Publication statusPublished - 1 Feb 2023


  • AIDS
  • antiretroviral therapy
  • cohort studies
  • HIV
  • Quality of life

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