Comorbidities, health-related quality of life and its associated factors among people living with HIV/AIDS in Gandaki Province of Nepal

Background HIV/AIDS remains a public health concern globally. Comorbidities add to the disease burden among people living with HIV (PLHIV) and may be associated with poorer health-related quality of life. This study aimed to assess the prevalence of comorbidities, health-related quality of life (HRQoL), and associated factors among people living with HIV in Gandaki Province, Nepal. Methods A cross-sectional study was conducted at the antiretroviral therapy (ART) centre of Western Regional Hospital, Pokhara. PLHIV registered at the ART centre were selected using simple random sampling. A multivariable logistic regression model was used to explore factors associated with HRQoL. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results A total of 337 PLHIV participated in the study. The mean overall HRQoL score was 6.25 ± 1.87, and 52.2% of participants reported poor quality of life. At least one comorbidity was present in 28.2% of participants. The most frequently reported comorbidities were hypertension (36.8%), diabetes (33.7%), tuberculosis (14.9%), hepatitis B (10.6%), and hepatitis C (4.3%). PLHIV with comorbidities had higher odds of poor HRQoL compared with those without comorbidities (AOR = 1.65; 95% CI: 0.98–2.78). Factors associated with comorbidities included marital status, family structure, education, occupation, current alcohol consumption, having a migrant worker spouse, CD4 count, transportation costs, perceived behaviour of healthcare workers, and HRQoL across all except the physical domain. Conclusions Comorbidities were common among people living with HIV. The findings suggest a high prevalence of poor quality of life among PLHIV, with comorbidities potentially associated with poorer HRQoL. These findings underscore the need for integrated interventions that address both health and social factors, including community engagement strategies.