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Synergist effect of antiretroviral therapy adherence and viral load suppression on quality of life of people with HIV/AIDS

12 January 2023
Volume 32 · Issue 1



This study investigated the synergistic and independent effects of adherence to antiretroviral therapy (ART) and viral load on quality of life (QoL) among people with HIV/AIDS.


This was a cross-sectional study of 129 patients with HIV/AIDS. The WHOQOL-BREF and the Morisky Medication Adherence Scale were used to measure QoL and adherence respectively. Information on viral load and CD4 cell count was obtained from patients' records and verified by a physician. An additive interaction method was used to estimate the synergistic effect of the linear regression.


Patients who were adhering to ART and had an undetectable viral load had significantly higher scores on four domains of QoL − environment, physical health, social relationships and psychological − than those who were non-adherent. Moreover, ART adherence and undetectable viral load had a positive synergistic effect on QoL after controlling for covariate variables.


Participants were more likely to have a good QoL if they had both undetectable viral loads and good ART adherence.

HIV and AIDS are regarded as global public health threats and pose a considerable challenge to healthcare systems (UNAIDS, 2022); AIDS has gone from being a fatal disease to a chronic condition (Zhou et al, 2020). There are approximately 38.4 million individuals diagnosed with HIV, with 1.5 million new infections occurring in 2021 (UNAIDS, 2022).

In Indonesia, the number of individuals with HIV declined from 640 000 in 2019 (UNAIDS, 2019) to 540 000 in 2022 (UNAIDS, 2022). However, the mortality rate is approximately 4.44% in individuals diagnosed with HIV/AIDS (UNAIDS, 2019). The high prevalence of early mortality in patients with HIV/AIDS means the factors that determine quality of life (QoL) related to disease burden and therefore health need to be better identified (Castro et al, 2019).

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