Evaluation of the Associations Between Medication Adherence, Polypharmacy, and Health-Related Quality of Life in People Living with HIV: A Cross-Sectional Study

Human immunodeficiency virus (HIV) is increasingly managed as a chronic condition, making health-related quality of life (HRQoL) an important long-term care outcome. The proposed “fourth 90” emphasises good quality of life among virally suppressed people. This study assessed HRQoL and examined associations with sociodemographic, clinical, and medication-related characteristics among people living with HIV. This single-centre, cross-sectional study was conducted at a tertiary-care infectious diseases clinic from June to December 2024. Medication adherence and HRQoL were assessed with the Medication Adherence Report Scale (MARS-5) and the 36-item Short Form Health Survey (SF-36). Descriptive and unadjusted analyses preceded domain-specific multivariable linear regression. Among 108 participants (82.4% male), 74.1% met the predefined adherence threshold. SF-36 scores were concentrated near the upper end for physical functioning, physical role limitations, social functioning, and emotional role limitations, whereas vitality/energy had the lowest median score (77.5). After simultaneous adjustment, university-level education or higher was associated with higher physical functioning (B = 3.71); each 10-year age increase with higher vitality/energy (B = 4.67), social functioning (B = 4.00), and emotional role limitations (B = 6.68); current smoking with lower vitality/energy (B = − 12.69) and mental health (B = − 7.39); each five-year increase in ART duration with lower vitality/energy (B = − 5.17); and polypharmacy with lower emotional role limitations (B = − 20.45). HRQoL scores were near the upper end in several domains, but vitality/energy was comparatively lower. Routine multidimensional HRQoL assessment may support individualized HIV care.