Analysis of the factors associated with meaning in life among people living with HIV/AIDS via a structural equation model: a cross-sectional study

Strong evidence shows that meaning in life (MIL) is a pivotal variable for improving the mental health and quality of life among people living with HIV/AIDS (PLWHA). However, the current level of MIL, its associated factors, and the pathways linking those modifiable factors to MIL among Chinese PLWHA are still unclear. This study was a cross-sectional survey among 518 PLWHA from January to May 2025 in Shanghai, China. Measurements were 6 questionnaires to collect general information, MIL, and modifiable variables, including psychological capital, social support, perceived discrimination, and severity of symptoms. Descriptive analysis, independent samples t-test, one-way ANOVA, Pearson’s correlation analysis, and structural equation modeling were conducted for data analysis. Overall, the mean MIL score of PLWHA was 48.27 (SD = 9.93). The final structural equation model demonstrated a good fit. Psychological capital represents a crucial associated factor, demonstrating a direct positive effect on MIL (β = 0.853, p < 0.001). Social support has indirectly positive effect on MIL, while perceived discrimination and severity of symptoms have indirectly negative effect on MIL. These findings underscore that future interventions enhancing MIL among PLWHA can be guided by the model proposed in this study, particularly those targeting psychological capital, for better well-being.