Factors Associated with Quality of Life among People Living with HIV/AIDS in Mali, 2023

Factors Associated with Quality of Life among People Living with HIV/AIDS in Mali, 2023 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors Associated with Quality of Life among People Living with HIV/AIDS in Mali, 2023 Nouhoum Telly, Abou Sogodogo, Oumar Sangho, Souleymane S Diarra, and 11 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6262015/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 26 You are reading this latest preprint version Abstract Introduction HIV is a source of concern, profoundly affecting the quality of life (QoL) of those affected. This study aimed to identify factors associated with the QoL of people living with HIV/AIDS (PLHIV) in Bamako in 2023. Methods : A cross-sectional study including 722 PLHIV was conducted in Bamako from January to September 2023. Data on sociodemographic, clinical and therapeutic characteristics were collected. The WHOQOL-HIV-BREF instrument was used to assess domains in patients' quality of life. Linear regression was performed using SPSS25 software, with a significant level of 5%. Results The mean age of study population was 41.35 (SD = 0.45) years, and women represented 78%. PLHIV reported a diminished QoL, with an overall score of 9.718. Domain-specific scores were as follow: physical health (15.637); psychological health (12.289); social relations (12.929); and environment (11.717). A diminished QoL was associated with being female, older age, having a low monthly income, being divorced or widowed, and not having formal education. Clinical and paraclinical factors such as low body mass index, presence of symptoms, comorbidities, opportunistic infections, and therapeutic factors such as non-adherence to treatment were also linked with poor QoL. Conclusion People living with HIV in Bamako had poor QoL, with low scores in all domains. Several modifiable factors linked to this poor QoL such as low monthly income, body mass index, symptoms, comorbidities, opportunistic infections, and not adhering to antiretroviral treatment were identified. Efforts to improve care access, reduce socio-economic barriers, and increase public awareness of effective HIV/AIDS treatments are critical in improving the QoL for those living with HIV/AIDS. Factors PLHIV Antiretroviral Quality of Life Mali 1. Background Quality of life (QoL) is a complex and multidimensional issue encompassing physical, cognitive, emotional, and social functioning [ 1 , 2 ]. It is critical in the management of chronic diseases such as human immunodeficiency virus (HIV) infection [ 3 ]. HIV remains a global public health problem, with 39.9 million people worldwide living with the disease at the end of 2023 [ 4 ]. The majority of people living with HIV (PLHIV), approximately 65% (25.94 million), reside in sub-Saharan Africa [ 5 ]. Mali, similar to other West African countries, is classified as a generalized epidemic country, with a national prevalence of 1.1% in 2012–2013 [ 6 ]. However, prevalence is higher in key vulnerable populations, with a prevalence of 5.1% among people who inject drugs, 12.6% among men who have sex with men, and 8.7% among sex workers [ 7 ]. By December 31, 2023, 84.16% of the 69746 people living with HIV were receiving antiretroviral therapy [ 7 ]. In line with the Sustainable Development Goals (SDGs), global HIV strategies aim to end the HIV epidemic by 2030 [ 5 ]. To achieve this, UNAIDS has set a 95-95-95 target, with the goal of ensuring that 95% of all PLHIV have been diagnosed, are receiving antiretroviral therapy, and are virally suppressed by 2030 [ 8 ]. Due to improved and increasingly available care worldwide, HIV has evolved from an acute fatal infection to a chronic disease with a life expectancy similar to that of the general population [ 3 , 9 ]. However, PLHIV face multidimensional concerns affecting many aspects of their lives [ 10 ], even after viral load suppression [ 11 ]. This population group remains marginalized, limiting their access to essential health services, such as timely diagnoses, prevention measures, and effective treatment regiments [ 12 ]. The changing and multifaceted needs of PLHIV have led to a shift in HIV care goals, “going beyond viral suppression” [ 13 ]. Instead, the focus is now on ensuring a good health-related quality of life (HRQoL) at all stages of the HIV care continuum [ 14 ]. Therefore, the HRQoL of PLHIV proposed as the “fourth 95” goal, alongside the UNAIDS 95-95-95 targets [ 15 , 16 ]. This new approach focuses on the individual to address inequalities and improve the well-being and quality of life of PLHIV [ 17 ]. As the World Health Organization (WHO) notes, HRQoL is about how people perceive their position in life, considering their culture, values, goals, and expectations [ 18 ]. However, overall QoL goes beyond physical and mental health, also covering social, material and spiritual well-being [ 19 ]. Research has identified several factors associated with poor HRQoL, including low income, CD4 count below 350 cells/mm3, detectable viral load, aging, lack of adherence to treatment regiments, limited social support, and HIV-related stigma [ 20 – 22 ]. Most studies on the QoL of PLHIV have been conducted in Western countries, despite Africa carrying the highest burden of HIV. In low-income countries like Mali, where a political and security crisis has been ongoing since 2012, this creates a double burden, exacerbating the QoL of both the general population and PLHIV. To better understand and improve the QoL of PLHIV, studies in different settings are necessary. In this regard, HRQoL is a key indicator for evaluating the impact and quality of the healthcare system in Mali for PLHIV [ 23 ]. To our knowledge, no study has investigated quality of life scores and their associated factors among people living with HIV in Mali. This study seeks to address this gap by using a validated tool to measure quality of life and identify its related factors among PLHIV in Mali, to ultimately provide evidence and policy recommendations to enhance their QoL. 2. Materials and methods 2.1. Study setting The study took place at care sites including the Care, Support and Advice Center for People Living with HIV/AIDS (CESAC), the Infectious and Tropical Diseases Unit at the University Hospital Center (UHC) du Point G , the Gastroenterology Unit at the UHC Gabriel Touré , and all Care and Accompaniment Units (USAC) within the six District Health Centers (CSRéf) in Bamako . These sites serve the majority of PLHIV in Bamako and Mali. As of 2023, there were 35,134 people living with HIV in Bamako, making up 50.37% of the national total. 2.2. Type and period of study We conducted analytical cross-sectional study from January 1, to September 30 2023. 2.3. Study population The study involved PLHIV who were being followed up at the various care sites in Bamako. Individuals were included in the study if they met the following criteria: (1) they were 18 or older, (2) living with HIV/AIDS, (3) receiving care at one of the study sites, (4) they could answer the study questionnaires, and (5) they had given their voluntary and informed consent to participate. The following patients were not included in the study: (1) PLHIV newly initiated on antiretroviral therapy; (2) PLHIV not registered in the database of the site; (3) PLHIV unavailable to participate in the study. 2.4. Sample technique In proportion to the total number of patients followed, we divided the sample among the study sites. At each site, we used a non-probabilistic consecutive sampling method according to the number of participants chosen in proportion to the size of the list. Patients visiting for prescription renewals were approached and included if they met the inclusion criteria. If a site didn't reach its target number, patients from other sites were added to make up the difference. 2.5. Sample size Given that the dependent were quantitative variables, we calculated the study size using a form of mean estimation with a confidence interval. $$\:n=\:{\left(\frac{{Z}_{\alpha\:}.\:\sigma\:}{\text{d}}\right)}^{2}$$ Equation 1 : Formula for calculating minimum sample size Where: n: sample size. \(\:{Z}_{\alpha\:}\) : center-reduced normal distribution test, for a risk α of 5%, i.e. a confidence level of 95%, the \(\:{Z}_{\alpha\:}\) is 1.96. d: desired precision (margin of error of the mean). In the Maleki et al study [ 24 ], the overall mean for QoL was 32.995, with a margin of error of 5% and a standard deviation of 18.10. The sample size was therefore 463 participants. To account for potential gaps or non-responses, we increased this number by 10%, resulting in a total estimated sample size of 509 PLHIV. In our study, we surveyed 722 people living with HIV, ensuring sufficient power for the study. 2.6. Study Procedures The survey days were allocated according to the days on which adult PLHIV visited the care sites. All PLHIV seen by the investigator at different sites were enrolled in the study if they met the inclusion criteria. Before participating in the study, PLHIV were informed of the study's objectives, potential risks, and benefits so they could give their free and informed consent. Interviews were conducted in isolated locations to ensure confidentiality. Participants were invited to complete the questionnaire themselves. For those who had difficulty filling in the form (e.g., due to low literacy levels), the questionnaire was explained to them in French or Bambara. Patients' medical records were used to collect data on HIV type, CD4 count, and viral load. Data on participants' quality of life were collected using the WHO's Quality of Life for People Living with HIV (WHOQOL-HIV BREF) instrument. 2.7. Measures The WHO’s QoL instrument for PLHIV (WHOQOL-HIV BREF) is a multidimensional profile comprising 26 items covering 4 domains: Physical, Psychological, Social relations, and Environment, as well as two general items (global perception of quality of life and global perception of health) [ 25 , 26 ]. Participants rated their responses using a 5-item Likert scale, rating their experiences over the past two weeks. For example, when asked about their QoL, they chose from the following response options: 1. Very poor, 2. Poor, 3. Neither good nor bad, 4. Good, or 5. Very good. The WHOQOL-HIV-BREF group’s scoring method was used to calculate the summarized domain scores and total QoL scores [ 25 ]. The response values for each item contributed equally to the corresponding domain scores. The study’s outcomes covered various domains of the WHOQOL-HIV, including global perception of QoL, global perception of health, physical health, psychological health, social relationships and patient environment. Sociodemographic variables included gender (male/female), age (mean ± standard deviation), age range (≤ 40 years/> 40 years), monthly income (< 100000FcFA/≥100000 FCFA), formal education (yes/no), and marital status (married/widowed/single/divorced). The clinical variables examined were body mass index (Kg/m 2 ) (≥ 18.5/ 12 months), presence of symptoms (yes/no), type of symptoms, presence of stigma (yes/no), presence of comorbidities (yes/no), type of comorbidities, presence of opportunistic diseases (yes/no), type of opportunistic diseases. Therapeutic and paraclinical variables included treatment regimen, notion of treatment discontinuation (yes/no), type of HIV (HIV-1/HIV-2/HIV-1 and 2), availability of viral load results (yes/no), viral load results (undetectable/detectable), availability of CD4 count (yes/no), CD4 count result (cells/mm3) (> 350/≤ 350). The questionnary is available in ( supplementary material 1 ) 2.8. Data collection and analysis Data were collected on a pre-tested individual survey form through direct interviews and participants' medical records. To reduce the risk of patients refusing to participate due to concerns about confidentiality, we used a paper questionnaire instead of electronic collection methods. The WHOQOL-HIV-BREF QoL domain scores were calculated using the WHO platform at https://www.futurefeet.eu/chart2/WHOQOL-fr.php (last consulted on August 15 2023). After the domain calculations, the survey forms were saved on the KoBoToolbox platform. The file was extracted in Excel format and imported into SPSS (statistical package for the social sciences) version 25. Inter-domain correlations were calculated between the different domains of the WHOQOL-HIV-BREF instrument to assess its internal consistency and reliability. Simple and multiple linear regressions were performed to identify factors associated with QoL, using the WHOQOL-HIV-BREF items as dependent variables (i.e., global perception of QoL, global perception of health, physical health, psychological health, social relationships and environment). We estimated the beta regression coefficient (β) and its 95% confidence interval (IC95%). Associations were considered significant when the p-value was less than 0.05. 3. Results 3.1. Socio-demographic characteristics During the study period, we surveyed a total of 722 patients living with HIV/AIDS in nine (9) HIV care sites in Bamako in 2023. The majority of PLHIV (78%) in our study were women, with a sex ratio (M/F) of 0.3. More than half participants (51%) were aged 40 or under, with a mean age of 41.35 ± 0.45 years. Most participants (56.6%) were married, and 53% had received formal education. The majority (87.4%) of the participants had a low income, making less than 100,000 CFA francs each month. Detailed socio-demographic and clinical characteristics are shown in Table I. 3.2. Clinical characteristics With regards to clinical characteristics, most PLHIV (90.7%) in our study had a body mass index greater than 18.5 kg/m 2 . In 83.2% of cases, more than twelve months had passed since their HIV diagnosis. About a third of patients (34.5%) were symptomatic, with coughs and colds being the most common symptoms, affecting 16.1% and 14.1% of cases respectively. Comorbidities were present in 21.2% of cases, with peptic ulcer disease, hypertension, and diabetes being the most common, affecting 50.3%, 34%, and 12.4% respectively. HIV/AIDS-related opportunistic diseases were found in 7.8% of the people surveyed, with non-tuberculous pneumonia being the main opportunistic infection in 71.4% of cases. Further details on the clinical characteristics are provided in Table II. 3.3. Therapeutic and paraclinical characteristics Almost all patients (99.3%) received Tenofovir/Lamivudine/Dolitegravir combination therapy. An antiretroviral treatment interruption occurred in 3.6% of the surveyed participants. Nearly all participants had HIV-1 infection, accounting for 97.4% of cases. Viral load results were available for 40.6% of patients and were undetectable in 98% of these cases. CD4 counts were available for 3.5% of patients, with 80% of them being above 350 cells/mm3. The therapeutic, virological, and immunological characteristics are shown in Table III . 3.4. WHOQOL- HIV-BEF In our study, we found significant associations between all domains of the WHOQOL-HIV-BREF. The environment and psychology domains showed the strongest correlation (r = 0.707, p < 0.001). In contrast, the lowest correlation was between social relations and overall health perception (r = 0.228, p < 0.001) ( Table IV ). The environmental and psychological domains had the lowest mean scores, while the physical health domain had the highest. Cronbach's alpha ranged from 0.749 to 0.808 across the four domains, and 0.826 for the entire instrument. Further details on the domain mean scores are shown in Table V . 3.5. Factors associated with the domains of QoL among PLHIV in Bamako Factors associated with global perception of QoL and global perception of health among PLHIV in Bamako Factors associated with poor global perception quality of life were a lack of formal education (β adj=-0,600, p < 0,001 ), being divorced (βadj=-0,538, p < 0,001) or widowed (β adj=-0,438, p < 0,001 ), a BMI of less than 18.5 kg/m2 (β adj=-0,656, p < 0,001 ), experiencing symptoms (βadj=-0,55, p < 0,001), not adhering to ART (β adj=-0,538, p = 0,046 ), and having HIV for less than 12 months (β adj=-0,365, p < 0,001 ). Factors associated with poor global perception of health included being female (β adj= -0,742, p = 0,003 ), being over 40 (β adj= -0,952, p < 0,001 ), lack of formal education (β adj= -0,656, p = 0,022 ), having a low monthly income (β adj= -0,424, p = 0,032 ), a BMI of less than 18.5 (β adj=-0,674, p = 0,042 ), experiencing symptoms (β adj=-2,597, p < 0,001 ), having comorbidities (β adj=-1,02,p < 0,001 ), having opportunistic infections (β adj=-0,884, p = 0,026 ), and having HIV for less than 12 months (β adj=-0,912, p < 0,001 ) ( Table VI ). Factors associated with physical and psychological health domains among PLHIV in Bamako Factors associated with poor physical health in PLHIV included being female (β adj=-0.698, p = 0.006 ); being over 40 (β adj=-0.809, p < 0.001 ); lacking formal education (βadj=-0.423, p = 0.035); and having a low monthly income (β adj=-0.752, p = 0.012 ). Additionally, experiencing symptoms (β adj=-2.674, p < 0.001 ), comorbidities (β adj=-0.927, p < 0.001 ), and opportunistic diseases (β adj=-1.019, p = 0.010 ) were also associated with poor physical health. In the psychological domain, factors linked to poor psychological health included being female (β adj=-0.880, p = 0.004 ); lacking formal education (β adj=-0.855, p < 0.001 ); having a low income (β adj=-1.409, p < 0.001 ); being divorced (β adj=-1.260, p = 0.007 ) or widowed ( βadj=-1.409, p < 0.001 ); experiencing symptoms (β adj=-1.937, p < 0.001 ) and opportunistic diseases (β adj=-1.290, p = 0.007 ); not adhering to ART (β adj=-0.930, p = 0.004 ); and having HIV for less than 12 months (β adj=-0.903, p = 0.003 ). ( Table VII ). Factors associated with social relations and environment domains among PLHIV in Bamako Factors associated with poor social relations in PLHIV included a lack of formal education (β adj=-0.610, p = 0.009 ); being divorced (β adj=-4.235, p < 0.001 ), single (β adj=-1.588, p < 0.001 ), or widowed (β adj=-2.996, p < 0.001 ), experiencing symptoms (β adj=-1.098, p < 0.001 ), and not adhering to ART (β adj=-0.637, p = 0.043 ). On the other hand, a low monthly income ( βadj=-1.658, p < 0.001 ), lack of formal education (β adj=-1.100, p < 0.001 ), being divorced (β adj=-1.337, p < 0.001 ) or widowed (β adj=-1.373, p < 0.001 ), experiencing symptoms (β adj=-1.292, p < 0.001 ), having comorbidities (β adj=-0.731, p = 0.002 ), and not adhering to ART (β adj=-0.848, p < 0.001 ) were associated with a poor quality of life in the environmental domain( Table VIII ). 4. Discussion 4.1. Description of study participants This cross-sectional study included 722 patients living with HIV/AIDS at nine HIV/AIDS care sites in Bamako in 2023. The mean age was 41.35 (SD = 0.45) years. Our results are similar to those Maleki et al in Iran who report 37.15 ± 9.46 years and 43.3 (SD = 10.4) years was reported in that of Akinboro et al, in Nigeria [ 27 ]. Monteiro F et al report a mean age of 40.74 years in 2016 [ 28 ]. This could be due to young people being more exposed to HIV risks and having a shorter life expectancy without antiretroviral treatment [ 29 ]. Most our study participants (78%) were also female. This is similar to Akinboro et al 2014 finding in Nigeria [ 27 ], where 71% of patients were female, and Nigusso et al 2020 study in Ethiopia [ 30 ], where 66.4% of patients were female. This predominance of females may be because most developing countries provide more services to prevent mother-to-child transmission (PMTCT). Within our study, PLHIV were mostly married, accounting for 56.6% of cases, while 26.5% were widowers. The high number of widowed patients in the HIV/AIDS population may be due to HIV often being discovered at an advanced stage, since it progresses slowly. As a result, partners usually find out about their spouse's HIV status after they have passed away. In our study, 52.5% of patients with HIV were informed about their status. A majority of our participants (53%) had received formal training. Other studies also found that most patients received formal education: Alford K et al 2023 [ 31 ] reported a majority of participants received schooling, while Liping et al [ 32 ] and Apodaca et al [ 33 ], found 95% and 96.1% of participants also received schooling, respectively. The high education levels may be explained by the idea that higher education is linked to a higher likelihood of getting voluntary HIV testing and participating in studies [ 34 ]. 4.2. Quality of life of PLHIV Mean QoL scores for PLHIV were 15.637 for physical health, 12.289 for psychological health, 12.929 for social relations, and 11.717 for environment. The overall score was 9.718. Our results indicate that PLHIV in Mali experience reduced QoL, with levels even lower than those reported in the literature. For instance, a systematic review in Iran reported a low mean QoL score of 32.99, with scores of 18.7, 30.79, 29.12, and 24.82 for environmental, physical, psychological, and social dimensions, respectively [ 24 ]. Similarly, studies in Brazil and Georgia found very low levels of QoL for PLHIV [ 35 , 36 ]. In resource-limited settings, PLHIV face significant challenges that affect their QoL. They experience stigmatization, marginalization, and daily struggles, such as participating in social life and fearing rejection by society. In LMIC contexts, many people associate HIV infection with risky sexual behavior, leading them to hide their illness and to become isolated, which can lead to mental challenges such as depression and anxiety [ 37 ]. 4.3. Factors associated with quality of life in PLHIV In the final linear regression model, female PLHIV reported a poor global perception of health, scoring low in both physical and psychological health domains. This finding is corroborated by previous research which has consistently shown that men tend to have a better QoL than women [ 38 , 39 ]. Within the African context, a study in South Africa found that female gender is significantly linked to psychological distress [ 37 ]. These findings may be attributed to the patriarchal social structure in Africa and other LMICs, which can worsen QoL when HIV is involved. Participants over 40 years old had a poor perception of their overall health and scored low in physical areas. This finding supports previous research, which shows that younger patients tend to have a better QoL [ 40 , 41 ]. One possible explanation for this is that older people living with HIV are more prone to opportunistic infections [ 42 ] due to their weakened immune system, which can worsen their health. In our study, being divorced or widowed was linked to a poorer overall view of PLHIV's health and lower scores in the psychological, social relations, and environmental areas compared to being married. The psychological pressure from divorce or bereavement, along with social exclusion, could contribute to a decline in QoL for PLWH. Like any other chronic illness, people living with HIV need someone to care for their physical, psychological, and social needs. Research by Akinboro et al [ 27 ] found that married or partnered patients had a better QoL in terms of social relationships than those who were separated or widowed. A study by Mthembu et al in South Africa [ 37 ] reported that marriage protects against psychological distress. Therefore, public education campaigns using mass media and specific training for the families of PLHIV are necessary. Additionally, creating groups of PLHIV on social networks could facilitate their social integration, reduce the psychological burden of the disease, reduce stigmatization, and improve the QoL of these patients. Patients without formal education tend to have a poor global QoL and a poor perception of their health, especially when it comes to physical, psychological, and environmental well-being. These findings are consistent with previous research showing that people with formal education have a better QoL [ 40 , 43 , 44 ]. This may be because higher education helps people better understand their disease, its complications, and the lifestyle changes needed to prevent transmission. It also helps them understand the importance of regular follow-up care. As a result, they can better manage their disease psychologically and prevent transmission. Monthly income emerged as a key demographic risk factor in the study. PLHIV with low monthly incomes tended to have a poor QoL and health, scoring low in physical, psychological, and environmental health. This finding is supported by Algaralleh et al's study [ 45 ], which linked unemployment and low income to a poor QoL in people living with HIV. Similar results have been reported in other studies [ 46 – 48 ]. Although HIV/AIDS treatment is free in Mali, a low income can still hinder access to care, patient adherence to treatment, and management of co-morbidities. Moreover, a decent income can facilitate social integration, providing opportunities for protection and health promotion. With regard to clinical characteristics, patients who experienced symptoms had poor QoL across all domains of the WHOQOL-HIV-BREF instrument. Similarly, patients with comorbidities and opportunistic illnesses had poor health perception and low scores in the physical and psychological health domains. Several studies, including those by Nobre et al [ 49 ], George et al [ 50 ] and Degroote et al [ 48 ], have found that comorbidities are associated with poor QoL. A study of medical-surgical wards also reported that patients with severe comorbidities had poor QoL [ 51 ]. Managing HIV comorbidities and opportunistic infections is one of the most challenging aspects of disease management. In our study, we had viral load results for 40.6% of patients, and of those, 98% had undetectable viral loads. CD4 counts were available for 3.5% of patients, with 80% of them showing counts above 350 cells/mm3. The WHO and its partners prioritize viral load suppression, aiming to reach 95% of people living with HIV by 2025. Globally, 71% of people living with HIV have achieved viral load suppression [ 52 ]. However, in Mali, this figure drops to 19.1% [ 53 ]. Reaching these targets remains a challenge in most LMICs like Mali. Virological and immunological status have been linked to poor QoL in PLHIV in previous studies [ 54 , 55 ]. In Nigeria, research by Akinboro et al [ 27 ] showed that individuals with a CD4 count of 350 cells/mm3 or higher reported a better QoL. However, we did not find any connection between viral load, CD4 count, and patients' QoL. However, a majority of our participants did lack available virological results. This highlights the need for health authorities to make greater efforts to ensure access to necessary equipment for proper patient follow-up. Limitations and strengths of the study Our study's findings should be considered in light of several limitations. First, the WHOQOL-BREF instrument measures QoL in the two weeks preceding the interview, however, participants may have provided information from a broader time period. Second, the cross-sectional design of the study does not allow us to establish a causal link. Additionally, the stigma attached to the disease and the subjectivity of the dimensions may affect the reliability of the answers. Finally, the lack of virological and immunological assessments limited the power of the study and our ability to conduct further tests. Despite these limitations, our study was the first to use the WHOQOL-HIV-BREF instrument to assess QoL in Mali. Our study was also large in scale, covering all main care sites for PLHIV in the Bamako district. Additionally, we used the WHOQOL-HIV-BREF instrument, which is specifically designed for HIV patients and has been proven to be cross-culturally valid. A qualitative study is needed to explore PLHIV's perceptions of their disease, the factors affecting their QoL, and ways to improve it. Conclusion People living with HIV in Bamako had a poor QoL, with low scores in all domains. The study identified several modifiable factors linked to this poor QoL such as low monthly income, body mass index, symptoms, comorbidities, opportunistic infections, and not adhering to antiretroviral treatment. To improve the QoL for PLHIV, health authorities and healthcare professionals must make a sustained effort to remove barriers to care and increase public awareness of effective HIV management. Abbreviations AIDS Acquired ImmunoDeficiency Syndrome CESAC Care, Support and Advice Center for People Living with HIV/AIDS CNESS Comité National d’Ethique pour la Santé et les Sciences de la vie CSRéf Centre de Santé de Référence HIV Human Immunodeficiency Virus HRQoL Health-Related Quality of Life MSDS Ministère de la Santé et du Développement Social PLHIV People Living with HIV/AIDS QoL Quality of Life SD Standard Deviation SDGs Sustainable Development Goals UHC University Hospital Center UNAIDS Joint United Nations Programme on HIV/AIDS. USAC Care and Accompaniment Units WHO World Health Organization WHOQOL-HIV-BREF World Health Organisation Quality of Live HIV-Bref Declarations Author contributions The contributions of each author to this manuscript are as follows: NT, AS, OS, SSD, CAC, SK and HD: contributed to the conception and designed the work. AS, AY, and AAT: contributed to the acquisition of the data. AS and AY: analyzed the data. KK, AS, NT, MTT, and ST: contributed to the interpretation of data. NT, AS: drafted the work. KK, MK, SD, ID, MTT, and OS: substantively revised the manuscript. All authors affirm that they have read and approved the submitted version of the manuscript. Data availability The data and all materials used in this study are available from the corresponding author on reasonable request. Funding No funding was provided for this study. Ethics approval and consent to participate This study was conducted in accordance with the principles of the Declaration of Helsinki (https://www.wma.net/policies-post/wma-declaration-of-helsinki/). The study protocol was approved by the National Ethics Committee for Life Sciences and Health of Mali (CNESS) under number N°2023/135/MSDS-CNESS. Free and informed consent was obtained from participants prior to inclusion. They received complete and accurate information, clearly communicated and fully understood, before giving their consent. Participants were informed about the study's objectives, risks, and potential benefits. However, data was securely stored and maintained with strict confidentiality. After the survey completion, participants received advice on treatment compliance and psychological support. The survey was conducted in a private location, where participants could complete the questionnaire on their own or have it explained to them. Each participant was assigned an anonymous identifying number. They could withdraw from the survey at any time without consequences. Consent for publication Not applicable Declaration of conflict of interest The authors of this study declare that they have no conflict of interest. Acknowledgements We sincerely thank all the participants who agreed to take part in the study. We would also like to thank the healthcare providers at all study sites for their invaluable support. References Megari K. Quality of Life in Chronic Disease Patients. Health Psychology Research [Internet]. 9 sept 2013 [cité 21 sept 2023];1(3). Disponible sur: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768563/ CDC. Concepts QVLS | CDC [Internet]. 2018 [cité 26 oct 2022]. Disponible sur: https://www.cdc.gov/hrqol/concept.htm Skogen V, Rohde GE, Langseth R, Rysstad O, Sørlie T, Lie B. Factors associated with health-related quality of life in people living with HIV in Norway. 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Tables Table I: Sociodemographic of people living with HIV in Bamako in 2023 (N= 722) Sociodographic and clinical characteristis n % Age range Mean (SD) = 41.35 (0.45) ≤ 40 years 368 51.0 > 40 years old 354 49.0 Sex Female 563 78.0 Male 159 22.0 Marital status Married 409 56.6 Widowed 191 26.5 Single 67 9.3 Divorcee 55 7.6 Formal Education Yes 383 53.0 No 339 47.0 Monthly income (CFA franc) Less than 100,000 631 87.4 Greater than or equal to 100,000 91 12.6 100,000 CFA franc = 165,44 $ US Table II: Clinical characteristics of people living with HIV in Bamako in 2023 n % Body mass index (Kg /m 2 ) (n= 722) ≥ 18.5 655 90.7 12 months 577 83.2 Presence of clinical symptoms (n= 722) Yes 249 34.5 No 473 65.5 Types of clinical symptoms* (n= 249) Cough 40 16.1 Common cold 35 14.1 Headaches 29 11.6 Low back sciatica 29 11.6 Abdominal pain 27 10.8 Aching 21 8.4 Anorexia 16 6.4 Chill/fever 14 5.6 Vertigo 12 4.8 Constipation 9 3.6 Edema of the lower limbs 7 2.8 Genital pruritus 7 2.8 Vomiting 5 2.0 Dyspnea 4 1.6 Diarrhea 3 1.2 Presence of comorbidity (n= 722) Yes 153 21.2 No 569 78.8 Types of comorbidity* (n= 153) Peptic ulcer 77 50.3 High blood pressure 52 34.0 Diabetes 19 12.4 Pregnancy 11 7.2 Others** 12 7.8 Presence of opportunistic diseases* (n= 722) Yes 153 21.2 No 569 78.8 Types of opportunistic diseases (n= 153) Non-TB bacterial pneumonias 40 71.4 Oral and/or esophageal candidiasis 16 28.6 Urinary/genital infection 14 25.0 Malaria 8 14.3 Tuberculosis 6 10.7 * Each patient was presented with all/multiple options. ** Others: tumor (3), genital infection (3), Asthma (2), sickle cell disease (2), viral hepatitis (1), heart disease (1). Table III: Therapeutic, virological and immunological characteristics of people living with HIV in Bamako in 2023 in the last 6 months n % Treatment plan (n= 722) Tenofovir/Lamivudine/Dolitegravir 717 99.3 Tenofovir/Lamivudine/Efavirenz 5 0.7 Concept of treatment discontinuation (n= 722) Yes 696 96.4 No 26 3.6 Type of HIV (n= 722) HIV-1 703 97.4 HIV-2 14 1.9 HIV-1&2 5 0.7 Availability of viral load results (n= 722) Yes 293 40.6 No 429 59.4 Viral load results (n = 293) Undetectable 286 98.0 Detectable 7 2.0 CD4 rate availability (n = 722) Yes 25 3.5 No 697 96.5 CD4 count result (cells/mm 3 ) (n = 25) > 350 20 80.0 ≤ 350 5 20.0 Total 25 100.0 The Tenofovir, Lamivudine and Dolitegravir regimen is the standard HIV management protocol in Mali. We noted a lack of availability of follow-up paraclinical data for patients. Table IV: Inter-domain correlation matrix of the WHOQOL-HIV-BREF instrument Domains 1 2 3 4 5 6 Overall perception of QoL 1,000 Overall perception of health 0.408* 1,000 Physical health 0.422* 0.501* 1,000 Psychological 0.701* 0.456* 0.590* 1,000 Social relations 0.493* 0.228* 0.404* 0.579* 1,000 Environment 0.613* 0.356* 0.510* 0.707* 0.547* 1,000 Note: * = p<0.001 The correlation matrix shows an adaptation of the WHOQOL-HIV-Bref tool in the Mali context. Table V: Mean scores and reliability coefficients of the WHOQOL-HIV-BREF domains among patients living with HIV in Bamako in 2023. Domains Mean scores ± standard deviation Cronbach's alpha if the element is deleted Physical health 15,637 ± 3,079 0.797 Psychological 12,289 ± 3,555 0.749 Social relations 12,929 ± 3,560 0.808 Environment 11,717 ± 2,893 0.769 Total 9,718 ± 5,476 0.826 The PLHIV in our study had a low average level of quality of life in all domains of quality of life. Table VI: Factors associated with global perception of QoL and health among PLHIV in Bamako 2023. Global perception of quality of life Global perception of health β brut [ 95% CI ] ; p-value β Adjusted [ 95% CI ] ; p-value β brut [ 95% CI ] ; p-value β Adjusted [ 95% CI ] ; p-value Sex -0.336 [-0.548; -0.124]; 0.002 0.014 [-0.196; 224]; 0.897 -0.290 [-0.489; -0.090]; 0.004 -0.742 [-1.236; -0.248]; 0.003 Age -0.120 [-0.297; 0.057]; 0.184 0.051 [-0.129; 0.230]; 0.578 -0.059 [-0.226; 0.107]; 0.483 -0.952 [-1.379; -0.525]; < 0.001 Income -0.841 [-1.099;-0.582]; <0.001 -0.600[-0.846; -0.355]; <0.001 -0.490 [-0.742; -0.251]; < 0.001 -0.656 [-1.217; -0.095]; 0.022 Schooling -0.580 [-0.752; -0.409]; <0.001 -0.375 [-0.540; -0.209]; <0.001 -0.293 [-0.457; 0.128]; < 0.001 -0.424 [-0.812; -0.36]; 0.032 Single - 0.050 [-0.253; 0.354]; 0.744 -0.052[-0.341; 0.237]; 0.723 0.210 [-0.081; 0.502]; 0.158 0.068 [-0.750; 0.613]; 0.845 Divorcee -0.646 [-0.977; 0.316]; <0.001 -0.538[-0.854; -0.222]; <0.001 -0.041[-0.359; 0.277]; 0.802 0.061 [-0.678; 0.800]; 0.872 Widowed -0.588 [-0.790; -0.386]; <0.001 -0.438[-0.643; -0.232]; <0.001 -0.212[-0.406; 0.018]; 0.032 * -0.232 [-0.714; 0.250]; 0.345 BMI -0.596 [-0.897; -0.295]; <0.001 -0.379[-0.643; -0.115]; 0.005 -0.596[-0.879; -0.314]; <0.001 -0.674 [-1.324; -0.024]; 0.042 Stigma -0, 860 [-1.620; -0.115]; 0.024 -0, 185 [-0.936; 0.566]; 0.630 -0.287 [-0.996; 0.422]; 0.428 0.838 [-0.931; 2.607]; 0.353 Symptoms -0.768 [-0.945; -0.591]; <0.001 -0.551[-0.724; -0.377]; <0.001 -0.782 [-0.946; -0.617]; <0.001 -2.597 [-3.005; -2.189]; <0.001 Comorbidities -0.356 [-0.977; 0.316]; < 0.001 -0, 182 [-0.381; -0.018]; 0.074 -0.224[-0.426; -0.022]; 0.030 -1.020 [-1.488; -0.552]; <0.001 Opportunists -0.621 [-0.948; -0.295]; < 0.001 -0, 285 [-0.613; -0.044]; 0.089 -0.760 [-1.064; -0.455]; <0.001 -0.884 [-1.659; -0.108]; 0.026 HIV duration -0.295 [-0.542; -0.048]; 0.019 -0.365 [-0.575; -0.155]; <0.001 -0.477 [-0.708; -0.246]; <0.001 -0.912 [-1.437; -0.387]; <0.001 ARTnon-compliance -0.257 [-0.498; -0.017]; 0.036 -0.226 [-0.448; -0.004]; 0.046 -0.373 [-0.597; -0.148]; <0.001 -0.237 [-0.757; 0.284]; 0.373 Viral load 0.581 [-0.325; 1.488]; 0.209 0.330 [-0.529; 1.189]; 0.451 0.860 [-0.018; 1.738]; 0.055 0.710 [-0.154; 1.573]; 0.107 CD4 rate -0.350 [-1.382; 0.682]; 0.506 0.426 [-0.665; 1.517]; 0.444 -0.900 [-2.226; 0.426]; 0.184 -0.633 [-1.941; 0.675]; 0.343 Note : Gender [0= male; 1= female]; age [0= ≤ 40 years; 1 = ]; monthly income [0= ; 1= ≥ 100000], Schooling [0= yes; 1= no]; marital status [0 = married, 1 = divorced, 2 = single, 3 = widowed], BMI [0=≥18.5; 1=<18.5]; stigma [0=no; 1=Yes, symptom [0=no; 1=Yes]; comorbidities [0=no; 1=Yes]; opportunistic [0=no; 1=Yes]; HIV duration [0=≥12 months, 1=<12 months]; non-adherence [0=no; 1=Yes]; VL [0=no; 1=Yes], CD4 [0=≥350, 1=<350]. Ref = 0 . Table VII: Factors associated with physical and psychological health domains among PLHIV in Bamako in 2023. Physical health Psychological β brut [ 95% CI ] ; p-value β Adjusted [ 95% CI ] ; p-value β brut [ 95% CI ] ; p-value β Adjusted [ 95% CI ] ; p-value Sex -0.013 [-1.550; -0.477]; <0.001 -0.698[-1.196; -0.200]; 0.006 -1,705 [-2.318; -1.092]; <0.001 -0.880 [-1.484; -0.277]; 0.004 Age -1.112 [-1.554; -0.671]; <0.001 -0.809[-1.235;-0.383]; <0.001 -0.220 [-0.739; 0.298]; 0.404 -0.003 [-0.519; 0.513]; 0.991 Schooling -1.201 [-1.642; -0.760]; <0.001 -0.423 [-0.816;-0.031]; 0.035 -1.503 [-2.011; -0.996]; <0.001 -0.855 [-1.331; -0.380]; <0.001 Monthly income -1.245 [-1.897; -0.593]; <0.001 -0.752 [-0.168;-1.336]; 0.012 -2.018 [-2.763; -1, 272]; <0.001 -1.409 [-2.117; -0.702;]; <0.001 Divorce -0.304 [-1.155; -0.548]; 0.485 0.058 [-0.692; 0.808]; 0.879 -1,810 [-2,784; -0.837]; <0.001 -1.260 [-2.168; -0.351]; 0.007 Single -0.341 [-0.440; -1.123]; 0.392 -0.148 [-0.834; 0.538]; 0.672 -0.331 [-1.224; -0.563]; 0.468 -0.739 [-1.570; 0.091]; 0.081 Widowed -1.226 [-1.746; -0.706]; <0.001 -0.243 [-0.731; 0.246]; 0.330 -1,730 [-2.324; -1.136]; <0.001 -1.112 [-1.704; -0.521]; <0.001 Symptoms -3.081 [-3.496; -2.666]; <0.001 -2.674 [-3.086;-2.263]; <0.001 -2,576 [-3.088;-2.065]; <0.001 -1.937 [-2.435; -1.439]; <0.001 Comorbidity -1.515 [-2.053; -0.977]; <0.001 -0.927 [-1.400;-0.453]; <0.001 -1.024 [-1.654; -0.394]; <0.001 -0.431 [-1.005; 0.142]; 0.141 Opportunists -1,775 [-2.604; -0.946]; <0.001 -1.019 [-1.798; -0.239]; 0.010 -2, 302 [-3.256; -1,348]; <0.001 -1.290 [-2.234; -0.346]; 0.007 Stigma -0.859 [-2.778; -1.061]; 0.380 0.886 [-0.898; 2.669]; 0.330 -2,626 [-4.835; -0.417]; 0.020 -0.009 [-2.169; 2.152]; 0.994 ARTnon-ompliance -0.288 [-0.901; -0.325]; 0.357 -0.406 [-0.933; 0.121]; 0.131 -1.041 [-1.746; -0.337]; 0.004 -0.931 [-1.569; -0.292]; 0.004 TAR duration -0.903 [-1.508; -0.297]; 0.003 -0.873 [-1.550; -0.292]; 0.002 -1.236 [-1.933; -0.538]; <0.001 -0.903 [-1.508; -0.297]; 0.003 Viral load 1.151 [-1.121; 3.423]; 0.321 0.637 [-1.572; 2.847]; 0.572 2.850 [0.186; 5.515]; 0.036 2.167 [-0.358; 4.693]; 0.093 CD4 -1.135 [-3.969; -3,969]; 0.433 0.352 [-2.273; 2.977]; 0.792 -1.055 [-4.125; 2.015]; 0.501 0.200 [-2.867; 3.268]; 0.898 Note : Gender [0= male; 1= female]; age [0= ≤ 40 years; 1 = ]; monthly income [0= ; 1= ≥ 100000], Schooling [0= yes; 1= no]; marital status [0 = married, 1 = divorced, 2 = single, 3 = widowed], BMI [0=≥18.5; 1=<18.5]; stigma [0=no; 1=Yes, symptom [0=no; 1=Yes]; comorbidities [0=no; 1=Yes]; opportunistic [0=no; 1=Yes]; HIV duration [0=≥12 months, 1=<12 months]; non-adherence [0=no; 1=Yes]; VL [0=no; 1=Yes], CD4 [0=≥350, 1=<350]. Ref = 0 . Table VIII: Factors associated with social and environmental domains among PLHIV in Bamako in 2023. Social relations Environment β brut [ 95% CI ] ; p-value β Adjusted [ 95% CI ] ; p-value β brut [ 95% CI ] ; p-value β Adjusted [ 95% CI ] ; p-value Sex -1.467 [-2.084; -0.850]; <0.001 -0.315 [-0.897; 0.267]; 0.288 -1.239 [-1.739; -0.738]; <0.001 -0.280 [-0.757; 0.197]; 0.250 Age -0.872 [-1.387; 0.357]; <0.001 -0.278 [-0.775; 0.220]; 0.274 -0.477 [-0.897; -0.056]; 0.026 0.011 [-0.397; 0.419]; 0.957 Schooling -1.231 [-1.743; -0.719]; 0.000 -0.610 [-1.068; -0.151]; 0.009 -1.681 [-2.085; -1, 277]; 0.000 -1.100 [-1.476; -0.724]; <0.001 Income -1.305 [-2.060; -0.550]; <0.001 0.654 [-0.028; 1.336]; 0.060 -2.191 [-2.789; -1.594]; <0.001 -1.658 [-2.217; -1.099]; <0.001 Divorce -4.691 [-5.567; -3.815]; <0.001 -4.235 [-5.111; -3.359]; <0.001 -1.665 [-2.440; -0.891]; <0.001 -1.337 [-2.055; -0.619]; <0.001 Single -1.319 [-2.122; -0.515]; <0.001 -1.588 [-2.389; -0.787]; <0.001 0.041 [-0.670; 0.752]; 0.910 -0.299 [-0.955; 0.357]; 0.372 Widowed -3.377 [-3.911; -2.842]; <0.001 -2.996 [-3.566; -2.426]; <0.001 -1.918 [-2.390; -1, 445]; <0.001 -1.373 [-1.840; -0.906]; <0.001 Symptoms -1,737 [-2,268; -1, 206]; <0.001 -1.098 [-1.578; -0.617]; <0.001 -1.894 [-2.316; -1.473]; <0.001 -1.292 [-1.685; -0.898]; <0.001 Comorbidity -0.968 [-1.599; -0.337]; 0.003 -0.204 [-0.757; 0.349]; 0.470 -1.248 [-1.756; -0.740]; <0.001 -0.731 [-1.184; -0.278]; 0.002 Opportunists -1.441 [-2.405; -0.477]; 0.003 -0.430 [-1.340; -0.481]; 0.355 -1.474 [-2.255; -0.693]; <0.001 -0.655 [-1.401; 0.091]; 0.085 Stigma -0.924 [-1.125; -0.722]; <0.001 -1.898 [-3.981; 0.185]; 0.074 -1.842 [-3.642; -0.043]; 0.045 -0.210 [-1.917; 1.497]; 0.809 ARTnon-ompliance -0.524 [-1.232; 0.184]; <0.001 -0.637 [-1.252; -0.021]; 0.043 -0.811 [-1.384; -0.238]; 0.006 -0.848 [-1.353; -0.344]; <0.001 Duration -0.565 [-1.268; 0.138]; 0.115 -0.565 [-1.268; 0.138]; 0.115 -0.595 [-1.166; -0.024]; 0.041 -0.565 [-1.268; 0.138]; 0.115 Viral load 1.302 [-1.229; 3, 833]; 0.313 -0.114 [-2.272; 2.045]; 0.918 2.618 [0.451; 4.785]; 0.018 1.907 [-0.141; 3.955]; 0.068 CD4 0.015 [-3.704; 3, 734]; 0.994 1,469 [-1,291; 4,229]; 0,297 -1.250 [-3.754; 1, 254]; 0.328 -0.345 [-2.778; 2.088]; 0.781 Note : Gender [0= male; 1= female]; age [0= ≤ 40 years; 1 = ]; monthly income [0= ; 1= ≥ 100000], Schooling [0= yes; 1= no]; marital status [0 = married, 1 = divorced, 2 = single, 3 = widowed], BMI [0=≥18.5; 1=<18.5]; stigma [0=no; 1=Yes, symptom [0=no; 1=Yes]; comorbidities [0=no; 1=Yes]; opportunistic [0=no; 1=Yes]; HIV duration [0=≥12 months, 1=<12 months]; non-adherence [0=no; 1=Yes]; VL [0=no; 1=Yes], CD4 [0=≥350, 1=<350]. Ref = 0 Additional Declarations No competing interests reported. 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Traoré","email":"","orcid":"","institution":"Cellule Sectorielle de lutte contre le VIH/Sida, la tuberculose et les hépatites virales (CSLS-TBH)","correspondingAuthor":false,"prefix":"","firstName":"Mariame","middleName":"T","lastName":"Traoré","suffix":""},{"id":455809212,"identity":"eed01c94-84b8-45d8-a45e-1b4dce65ff9e","order_by":12,"name":"Madina Konaté","email":"","orcid":"","institution":"Cellule Sectorielle de lutte contre le VIH/Sida, la tuberculose et les hépatites virales (CSLS-TBH)","correspondingAuthor":false,"prefix":"","firstName":"Madina","middleName":"","lastName":"Konaté","suffix":""},{"id":455809213,"identity":"107fa7ee-f172-494a-bba3-90e3e17ca253","order_by":13,"name":"Kassoum Kayentao","email":"","orcid":"","institution":"Malaria Research and Training Center of University of Sciences, Techniques and Technologies of Bamako","correspondingAuthor":false,"prefix":"","firstName":"Kassoum","middleName":"","lastName":"Kayentao","suffix":""},{"id":455809214,"identity":"2664b7ba-2bd6-41ee-8c06-0684b3501097","order_by":14,"name":"Seydou Doumbia","email":"","orcid":"","institution":"Department of Teaching and Research in Public Health and Specialties/ Faculty of Medecine and Odontostomatologie of Univesity of Sciences, Techniques and Technologies of Bamako","correspondingAuthor":false,"prefix":"","firstName":"Seydou","middleName":"","lastName":"Doumbia","suffix":""}],"badges":[],"createdAt":"2025-03-19 13:23:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6262015/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6262015/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82802874,"identity":"da5502cd-a910-484d-8b81-91878c6ffc86","added_by":"auto","created_at":"2025-05-15 11:43:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2153194,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6262015/v1/6c0708a2-ec17-46bf-906e-a252b161b193.pdf"},{"id":82802085,"identity":"ae854516-c9b4-4d77-ba7b-5f206eb3df6f","added_by":"auto","created_at":"2025-05-15 11:35:25","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":16303,"visible":true,"origin":"","legend":"","description":"","filename":"Questionnaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-6262015/v1/ab43e3393a90417b2cbb8889.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors Associated with Quality of Life among People Living with HIV/AIDS in Mali, 2023","fulltext":[{"header":"1. Background","content":"\u003cp\u003eQuality of life (QoL) is a complex and multidimensional issue encompassing physical, cognitive, emotional, and social functioning [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. It is critical in the management of chronic diseases such as human immunodeficiency virus (HIV) infection [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. HIV remains a global public health problem, with 39.9\u0026nbsp;million people worldwide living with the disease at the end of 2023 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The majority of people living with HIV (PLHIV), approximately 65% (25.94\u0026nbsp;million), reside in sub-Saharan Africa [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Mali, similar to other West African countries, is classified as a generalized epidemic country, with a national prevalence of 1.1% in 2012\u0026ndash;2013 [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, prevalence is higher in key vulnerable populations, with a prevalence of 5.1% among people who inject drugs, 12.6% among men who have sex with men, and 8.7% among sex workers [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. By December 31, 2023, 84.16% of the 69746 people living with HIV were receiving antiretroviral therapy [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn line with the Sustainable Development Goals (SDGs), global HIV strategies aim to end the HIV epidemic by 2030 [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. To achieve this, UNAIDS has set a 95-95-95 target, with the goal of ensuring that 95% of all PLHIV have been diagnosed, are receiving antiretroviral therapy, and are virally suppressed by 2030 [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Due to improved and increasingly available care worldwide, HIV has evolved from an acute fatal infection to a chronic disease with a life expectancy similar to that of the general population [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, PLHIV face multidimensional concerns affecting many aspects of their lives [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], even after viral load suppression [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This population group remains marginalized, limiting their access to essential health services, such as timely diagnoses, prevention measures, and effective treatment regiments [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe changing and multifaceted needs of PLHIV have led to a shift in HIV care goals, \u0026ldquo;going beyond viral suppression\u0026rdquo; [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Instead, the focus is now on ensuring a good health-related quality of life (HRQoL) at all stages of the HIV care continuum [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Therefore, the HRQoL of PLHIV proposed as the \u0026ldquo;fourth 95\u0026rdquo; goal, alongside the UNAIDS 95-95-95 targets [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This new approach focuses on the individual to address inequalities and improve the well-being and quality of life of PLHIV [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. As the World Health Organization (WHO) notes, HRQoL is about how people perceive their position in life, considering their culture, values, goals, and expectations [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, overall QoL goes beyond physical and mental health, also covering social, material and spiritual well-being [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Research has identified several factors associated with poor HRQoL, including low income, CD4 count below 350 cells/mm3, detectable viral load, aging, lack of adherence to treatment regiments, limited social support, and HIV-related stigma [\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMost studies on the QoL of PLHIV have been conducted in Western countries, despite Africa carrying the highest burden of HIV. In low-income countries like Mali, where a political and security crisis has been ongoing since 2012, this creates a double burden, exacerbating the QoL of both the general population and PLHIV. To better understand and improve the QoL of PLHIV, studies in different settings are necessary. In this regard, HRQoL is a key indicator for evaluating the impact and quality of the healthcare system in Mali for PLHIV [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. To our knowledge, no study has investigated quality of life scores and their associated factors among people living with HIV in Mali. This study seeks to address this gap by using a validated tool to measure quality of life and identify its related factors among PLHIV in Mali, to ultimately provide evidence and policy recommendations to enhance their QoL.\u003c/p\u003e"},{"header":"2. Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Study setting\u003c/h2\u003e \u003cp\u003eThe study took place at care sites including the \u003cem\u003eCare, Support and Advice Center for People Living with HIV/AIDS\u003c/em\u003e (CESAC), the \u003cem\u003eInfectious and Tropical Diseases Unit at the University Hospital Center (UHC) du Point G\u003c/em\u003e, the \u003cem\u003eGastroenterology Unit at the UHC Gabriel Tour\u0026eacute;\u003c/em\u003e, and all \u003cem\u003eCare and Accompaniment Units\u003c/em\u003e (USAC) within the six \u003cem\u003eDistrict Health Centers (CSR\u0026eacute;f) in Bamako\u003c/em\u003e. These sites serve the majority of PLHIV in Bamako and Mali. As of 2023, there were 35,134 people living with HIV in Bamako, making up 50.37% of the national total.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Type and period of study\u003c/h2\u003e \u003cp\u003eWe conducted analytical cross-sectional study from January 1, to September 30 2023.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Study population\u003c/h2\u003e \u003cp\u003eThe study involved PLHIV who were being followed up at the various care sites in Bamako. Individuals were included in the study if they met the following criteria: (1) they were 18 or older, (2) living with HIV/AIDS, (3) receiving care at one of the study sites, (4) they could answer the study questionnaires, and (5) they had given their voluntary and informed consent to participate. The following patients were not included in the study: (1) PLHIV newly initiated on antiretroviral therapy; (2) PLHIV not registered in the database of the site; (3) PLHIV unavailable to participate in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4. Sample technique\u003c/h2\u003e \u003cp\u003e In proportion to the total number of patients followed, we divided the sample among the study sites. At each site, we used a non-probabilistic consecutive sampling method according to the number of participants chosen in proportion to the size of the list. Patients visiting for prescription renewals were approached and included if they met the inclusion criteria. If a site didn't reach its target number, patients from other sites were added to make up the difference.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5. Sample size\u003c/h2\u003e \u003cp\u003eGiven that the dependent were quantitative variables, we calculated the study size using a form of mean estimation with a confidence interval.\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:n=\\:{\\left(\\frac{{Z}_{\\alpha\\:}.\\:\\sigma\\:}{\\text{d}}\\right)}^{2}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eEquation 1\u003c/b\u003e : Formula for calculating minimum sample size\u003c/p\u003e \u003cp\u003eWhere: n: sample size. \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{Z}_{\\alpha\\:}\\)\u003c/span\u003e\u003c/span\u003e: center-reduced normal distribution test, for a risk α of 5%, i.e. a confidence level of 95%, the \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{Z}_{\\alpha\\:}\\)\u003c/span\u003e\u003c/span\u003e is 1.96. d: desired precision (margin of error of the mean). In the Maleki et al study [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], the overall mean for QoL was 32.995, with a margin of error of 5% and a standard deviation of 18.10. The sample size was therefore 463 participants. To account for potential gaps or non-responses, we increased this number by 10%, resulting in a total estimated sample size of 509 PLHIV. In our study, we surveyed 722 people living with HIV, ensuring sufficient power for the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6. Study Procedures\u003c/h2\u003e \u003cp\u003eThe survey days were allocated according to the days on which adult PLHIV visited the care sites. All PLHIV seen by the investigator at different sites were enrolled in the study if they met the inclusion criteria. Before participating in the study, PLHIV were informed of the study's objectives, potential risks, and benefits so they could give their free and informed consent. Interviews were conducted in isolated locations to ensure confidentiality. Participants were invited to complete the questionnaire themselves. For those who had difficulty filling in the form (e.g., due to low literacy levels), the questionnaire was explained to them in French or Bambara. Patients' medical records were used to collect data on HIV type, CD4 count, and viral load. Data on participants' quality of life were collected using the WHO's Quality of Life for People Living with HIV (WHOQOL-HIV BREF) instrument.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.7. Measures\u003c/h2\u003e \u003cp\u003eThe WHO\u0026rsquo;s QoL instrument for PLHIV (WHOQOL-HIV BREF) is a multidimensional profile comprising 26 items covering 4 domains: Physical, Psychological, Social relations, and Environment, as well as two general items (global perception of quality of life and global perception of health) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Participants rated their responses using a 5-item Likert scale, rating their experiences over the past two weeks. For example, when asked about their QoL, they chose from the following response options: 1. Very poor, 2. Poor, 3. Neither good nor bad, 4. Good, or 5. Very good. The WHOQOL-HIV-BREF group\u0026rsquo;s scoring method was used to calculate the summarized domain scores and total QoL scores [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The response values for each item contributed equally to the corresponding domain scores.\u003c/p\u003e \u003cp\u003eThe study\u0026rsquo;s outcomes covered various domains of the WHOQOL-HIV, including global perception of QoL, global perception of health, physical health, psychological health, social relationships and patient environment. Sociodemographic variables included gender (male/female), age (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation), age range (\u0026le;\u0026thinsp;40 years/\u0026gt; 40 years), monthly income (\u0026lt;\u0026thinsp;100000FcFA/\u0026ge;100000 FCFA), formal education (yes/no), and marital status (married/widowed/single/divorced). The clinical variables examined were body mass index (Kg/m\u003csup\u003e2\u003c/sup\u003e) (\u0026ge;\u0026thinsp;18.5/\u0026lt; 18.5), time since diagnosis (\u0026le;\u0026thinsp;12 months/ \u0026gt; 12 months), presence of symptoms (yes/no), type of symptoms, presence of stigma (yes/no), presence of comorbidities (yes/no), type of comorbidities, presence of opportunistic diseases (yes/no), type of opportunistic diseases. Therapeutic and paraclinical variables included treatment regimen, notion of treatment discontinuation (yes/no), type of HIV (HIV-1/HIV-2/HIV-1 and 2), availability of viral load results (yes/no), viral load results (undetectable/detectable), availability of CD4 count (yes/no), CD4 count result (cells/mm3) (\u0026gt;\u0026thinsp;350/\u0026le; 350). The questionnary is available in (\u003cb\u003esupplementary material 1\u003c/b\u003e)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.8. Data collection and analysis\u003c/h2\u003e \u003cp\u003eData were collected on a pre-tested individual survey form through direct interviews and participants' medical records. To reduce the risk of patients refusing to participate due to concerns about confidentiality, we used a paper questionnaire instead of electronic collection methods. The WHOQOL-HIV-BREF QoL domain scores were calculated using the WHO platform at \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.futurefeet.eu/chart2/WHOQOL-fr.php\u003c/span\u003e\u003cspan address=\"https://www.futurefeet.eu/chart2/WHOQOL-fr.php\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (last consulted on August 15 2023). After the domain calculations, the survey forms were saved on the KoBoToolbox platform. The file was extracted in Excel format and imported into SPSS (statistical package for the social sciences) version 25.\u003c/p\u003e \u003cp\u003eInter-domain correlations were calculated between the different domains of the WHOQOL-HIV-BREF instrument to assess its internal consistency and reliability. Simple and multiple linear regressions were performed to identify factors associated with QoL, using the WHOQOL-HIV-BREF items as dependent variables (i.e., global perception of QoL, global perception of health, physical health, psychological health, social relationships and environment). We estimated the beta regression coefficient (β) and its 95% confidence interval (IC95%). Associations were considered significant when the p-value was less than 0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Socio-demographic characteristics\u003c/h2\u003e \u003cp\u003eDuring the study period, we surveyed a total of 722 patients living with HIV/AIDS in nine (9) HIV care sites in Bamako in 2023. The majority of PLHIV (78%) in our study were women, with a sex ratio (M/F) of 0.3. More than half participants (51%) were aged 40 or under, with a mean age of 41.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45 years. Most participants (56.6%) were married, and 53% had received formal education. The majority (87.4%) of the participants had a low income, making less than 100,000 CFA francs each month. Detailed socio-demographic and clinical characteristics are shown in \u003cb\u003eTable I.\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Clinical characteristics\u003c/h2\u003e \u003cp\u003eWith regards to clinical characteristics, most PLHIV (90.7%) in our study had a body mass index greater than 18.5 kg/m\u003csup\u003e2\u003c/sup\u003e. In 83.2% of cases, more than twelve months had passed since their HIV diagnosis. About a third of patients (34.5%) were symptomatic, with coughs and colds being the most common symptoms, affecting 16.1% and 14.1% of cases respectively. Comorbidities were present in 21.2% of cases, with peptic ulcer disease, hypertension, and diabetes being the most common, affecting 50.3%, 34%, and 12.4% respectively. HIV/AIDS-related opportunistic diseases were found in 7.8% of the people surveyed, with non-tuberculous pneumonia being the main opportunistic infection in 71.4% of cases. Further details on the clinical characteristics are provided in \u003cb\u003eTable II.\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Therapeutic and paraclinical characteristics\u003c/h2\u003e \u003cp\u003eAlmost all patients (99.3%) received Tenofovir/Lamivudine/Dolitegravir combination therapy. An antiretroviral treatment interruption occurred in 3.6% of the surveyed participants. Nearly all participants had HIV-1 infection, accounting for 97.4% of cases. Viral load results were available for 40.6% of patients and were undetectable in 98% of these cases. CD4 counts were available for 3.5% of patients, with 80% of them being above 350 cells/mm3. The therapeutic, virological, and immunological characteristics are shown in \u003cb\u003eTable III\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.4. WHOQOL- HIV-BEF\u003c/h2\u003e \u003cp\u003eIn our study, we found significant associations between all domains of the WHOQOL-HIV-BREF. The environment and psychology domains showed the strongest correlation (r\u0026thinsp;=\u0026thinsp;0.707, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In contrast, the lowest correlation was between social relations and overall health perception (r\u0026thinsp;=\u0026thinsp;0.228, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (\u003cb\u003eTable IV\u003c/b\u003e).\u003c/p\u003e \u003cp\u003eThe environmental and psychological domains had the lowest mean scores, while the physical health domain had the highest. Cronbach's alpha ranged from 0.749 to 0.808 across the four domains, and 0.826 for the entire instrument. Further details on the domain mean scores are shown in \u003cb\u003eTable V\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.5. Factors associated with the domains of QoL among PLHIV in Bamako\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eFactors associated with global perception of QoL and global perception of health among PLHIV in Bamako\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eFactors associated with poor global perception quality of life were a lack of formal education (β\u003cem\u003eadj=-0,600, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e), being divorced (βadj=-0,538, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001) or widowed (β\u003cem\u003eadj=-0,438, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e), a BMI of less than 18.5 kg/m2 (β\u003cem\u003eadj=-0,656, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e), experiencing symptoms (βadj=-0,55, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001), not adhering to ART (β\u003cem\u003eadj=-0,538, p\u0026thinsp;=\u0026thinsp;0,046\u003c/em\u003e), and having HIV for less than 12 months (β\u003cem\u003eadj=-0,365, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e). Factors associated with poor global perception of health included being female (β\u003cem\u003eadj= -0,742, p\u0026thinsp;=\u0026thinsp;0,003\u003c/em\u003e), being over 40 (β\u003cem\u003eadj= -0,952, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e), lack of formal education (β\u003cem\u003eadj= -0,656, p\u0026thinsp;=\u0026thinsp;0,022\u003c/em\u003e), having a low monthly income (β\u003cem\u003eadj= -0,424, p\u0026thinsp;=\u0026thinsp;0,032\u003c/em\u003e), a BMI of less than 18.5 (β\u003cem\u003eadj=-0,674, p\u0026thinsp;=\u0026thinsp;0,042\u003c/em\u003e), experiencing symptoms (β\u003cem\u003eadj=-2,597, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e), having comorbidities (β\u003cem\u003eadj=-1,02,p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e), having opportunistic infections (β\u003cem\u003eadj=-0,884, p\u0026thinsp;=\u0026thinsp;0,026\u003c/em\u003e), and having HIV for less than 12 months (β\u003cem\u003eadj=-0,912, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/em\u003e) (\u003cb\u003eTable VI\u003c/b\u003e).\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eFactors associated with physical and psychological health domains among PLHIV in Bamako\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eFactors associated with poor physical health in PLHIV included being female (β\u003cem\u003eadj=-0.698, p\u0026thinsp;=\u0026thinsp;0.006\u003c/em\u003e); being over 40 (β\u003cem\u003eadj=-0.809, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e); lacking formal education (βadj=-0.423, p\u0026thinsp;=\u0026thinsp;0.035); and having a low monthly income (β\u003cem\u003eadj=-0.752, p\u0026thinsp;=\u0026thinsp;0.012\u003c/em\u003e). Additionally, experiencing symptoms (β\u003cem\u003eadj=-2.674, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), comorbidities (β\u003cem\u003eadj=-0.927, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), and opportunistic diseases (β\u003cem\u003eadj=-1.019, p\u0026thinsp;=\u0026thinsp;0.010\u003c/em\u003e) were also associated with poor physical health. In the psychological domain, factors linked to poor psychological health included being female (β\u003cem\u003eadj=-0.880, p\u0026thinsp;=\u0026thinsp;0.004\u003c/em\u003e); lacking formal education (β\u003cem\u003eadj=-0.855, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e); having a low income (β\u003cem\u003eadj=-1.409, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e); being divorced (β\u003cem\u003eadj=-1.260, p\u0026thinsp;=\u0026thinsp;0.007\u003c/em\u003e) or widowed (\u003cem\u003eβadj=-1.409, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e); experiencing symptoms (β\u003cem\u003eadj=-1.937, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e) and opportunistic diseases (β\u003cem\u003eadj=-1.290, p\u0026thinsp;=\u0026thinsp;0.007\u003c/em\u003e); not adhering to ART (β\u003cem\u003eadj=-0.930, p\u0026thinsp;=\u0026thinsp;0.004\u003c/em\u003e); and having HIV for less than 12 months (β\u003cem\u003eadj=-0.903, p\u0026thinsp;=\u0026thinsp;0.003\u003c/em\u003e). (\u003cb\u003eTable VII\u003c/b\u003e).\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eFactors associated with social relations and environment domains among PLHIV in Bamako\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eFactors associated with poor social relations in PLHIV included a lack of formal education (β\u003cem\u003eadj=-0.610, p\u0026thinsp;=\u0026thinsp;0.009\u003c/em\u003e); being divorced (β\u003cem\u003eadj=-4.235, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), single (β\u003cem\u003eadj=-1.588, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), or widowed (β\u003cem\u003eadj=-2.996, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), experiencing symptoms (β\u003cem\u003eadj=-1.098, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), and not adhering to ART (β\u003cem\u003eadj=-0.637, p\u0026thinsp;=\u0026thinsp;0.043\u003c/em\u003e). On the other hand, a low monthly income (\u003cem\u003eβadj=-1.658, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), lack of formal education (β\u003cem\u003eadj=-1.100, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), being divorced (β\u003cem\u003eadj=-1.337, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e) or widowed (β\u003cem\u003eadj=-1.373, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), experiencing symptoms (β\u003cem\u003eadj=-1.292, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), having comorbidities (β\u003cem\u003eadj=-0.731, p\u0026thinsp;=\u0026thinsp;0.002\u003c/em\u003e), and not adhering to ART (β\u003cem\u003eadj=-0.848, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e) were associated with a poor quality of life in the environmental domain(\u003cb\u003eTable VIII\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.1. Description of study participants\u003c/h2\u003e \u003cp\u003e This cross-sectional study included 722 patients living with HIV/AIDS at nine HIV/AIDS care sites in Bamako in 2023. The mean age was 41.35 (SD = 0.45) years. Our results are similar to those Maleki et al in Iran who report 37.15 ± 9.46 years and 43.3 (SD = 10.4) years was reported in that of Akinboro et al, in Nigeria [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Monteiro F et al report a mean age of 40.74 years in 2016 [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. This could be due to young people being more exposed to HIV risks and having a shorter life expectancy without antiretroviral treatment [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Most our study participants (78%) were also female. This is similar to Akinboro et al 2014 finding in Nigeria [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], where 71% of patients were female, and Nigusso et al 2020 study in Ethiopia [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], where 66.4% of patients were female. This predominance of females may be because most developing countries provide more services to prevent mother-to-child transmission (PMTCT).\u003c/p\u003e \u003cp\u003eWithin our study, PLHIV were mostly married, accounting for 56.6% of cases, while 26.5% were widowers. The high number of widowed patients in the HIV/AIDS population may be due to HIV often being discovered at an advanced stage, since it progresses slowly. As a result, partners usually find out about their spouse's HIV status after they have passed away. In our study, 52.5% of patients with HIV were informed about their status. A majority of our participants (53%) had received formal training. Other studies also found that most patients received formal education: Alford K et al 2023 [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] reported a majority of participants received schooling, while Liping et al [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] and Apodaca et al [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], found 95% and 96.1% of participants also received schooling, respectively. The high education levels may be explained by the idea that higher education is linked to a higher likelihood of getting voluntary HIV testing and participating in studies [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.2. Quality of life of PLHIV\u003c/h2\u003e \u003cp\u003eMean QoL scores for PLHIV were 15.637 for physical health, 12.289 for psychological health, 12.929 for social relations, and 11.717 for environment. The overall score was 9.718. Our results indicate that PLHIV in Mali experience reduced QoL, with levels even lower than those reported in the literature. For instance, a systematic review in Iran reported a low mean QoL score of 32.99, with scores of 18.7, 30.79, 29.12, and 24.82 for environmental, physical, psychological, and social dimensions, respectively [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Similarly, studies in Brazil and Georgia found very low levels of QoL for PLHIV [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. In resource-limited settings, PLHIV face significant challenges that affect their QoL. They experience stigmatization, marginalization, and daily struggles, such as participating in social life and fearing rejection by society. In LMIC contexts, many people associate HIV infection with risky sexual behavior, leading them to hide their illness and to become isolated, which can lead to mental challenges such as depression and anxiety [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.3. Factors associated with quality of life in PLHIV\u003c/h2\u003e \u003cp\u003eIn the final linear regression model, female PLHIV reported a poor global perception of health, scoring low in both physical and psychological health domains. This finding is corroborated by previous research which has consistently shown that men tend to have a better QoL than women [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Within the African context, a study in South Africa found that female gender is significantly linked to psychological distress [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. These findings may be attributed to the patriarchal social structure in Africa and other LMICs, which can worsen QoL when HIV is involved.\u003c/p\u003e \u003cp\u003eParticipants over 40 years old had a poor perception of their overall health and scored low in physical areas. This finding supports previous research, which shows that younger patients tend to have a better QoL [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. One possible explanation for this is that older people living with HIV are more prone to opportunistic infections [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e] due to their weakened immune system, which can worsen their health.\u003c/p\u003e \u003cp\u003eIn our study, being divorced or widowed was linked to a poorer overall view of PLHIV's health and lower scores in the psychological, social relations, and environmental areas compared to being married. The psychological pressure from divorce or bereavement, along with social exclusion, could contribute to a decline in QoL for PLWH. Like any other chronic illness, people living with HIV need someone to care for their physical, psychological, and social needs. Research by Akinboro et al [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] found that married or partnered patients had a better QoL in terms of social relationships than those who were separated or widowed. A study by Mthembu et al in South Africa [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] reported that marriage protects against psychological distress. Therefore, public education campaigns using mass media and specific training for the families of PLHIV are necessary. Additionally, creating groups of PLHIV on social networks could facilitate their social integration, reduce the psychological burden of the disease, reduce stigmatization, and improve the QoL of these patients.\u003c/p\u003e \u003cp\u003ePatients without formal education tend to have a poor global QoL and a poor perception of their health, especially when it comes to physical, psychological, and environmental well-being. These findings are consistent with previous research showing that people with formal education have a better QoL [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. This may be because higher education helps people better understand their disease, its complications, and the lifestyle changes needed to prevent transmission. It also helps them understand the importance of regular follow-up care. As a result, they can better manage their disease psychologically and prevent transmission.\u003c/p\u003e \u003cp\u003eMonthly income emerged as a key demographic risk factor in the study. PLHIV with low monthly incomes tended to have a poor QoL and health, scoring low in physical, psychological, and environmental health. This finding is supported by Algaralleh et al's study [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e], which linked unemployment and low income to a poor QoL in people living with HIV. Similar results have been reported in other studies [\u003cspan additionalcitationids=\"CR47\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e–\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Although HIV/AIDS treatment is free in Mali, a low income can still hinder access to care, patient adherence to treatment, and management of co-morbidities. Moreover, a decent income can facilitate social integration, providing opportunities for protection and health promotion.\u003c/p\u003e \u003cp\u003eWith regard to clinical characteristics, patients who experienced symptoms had poor QoL across all domains of the WHOQOL-HIV-BREF instrument. Similarly, patients with comorbidities and opportunistic illnesses had poor health perception and low scores in the physical and psychological health domains. Several studies, including those by Nobre et al [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e], George et al [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e] and Degroote et al [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], have found that comorbidities are associated with poor QoL. A study of medical-surgical wards also reported that patients with severe comorbidities had poor QoL [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Managing HIV comorbidities and opportunistic infections is one of the most challenging aspects of disease management.\u003c/p\u003e \u003cp\u003eIn our study, we had viral load results for 40.6% of patients, and of those, 98% had undetectable viral loads. CD4 counts were available for 3.5% of patients, with 80% of them showing counts above 350 cells/mm3. The WHO and its partners prioritize viral load suppression, aiming to reach 95% of people living with HIV by 2025. Globally, 71% of people living with HIV have achieved viral load suppression [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. However, in Mali, this figure drops to 19.1% [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. Reaching these targets remains a challenge in most LMICs like Mali.\u003c/p\u003e \u003cp\u003eVirological and immunological status have been linked to poor QoL in PLHIV in previous studies [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. In Nigeria, research by Akinboro et al [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] showed that individuals with a CD4 count of 350 cells/mm3 or higher reported a better QoL. However, we did not find any connection between viral load, CD4 count, and patients' QoL. However, a majority of our participants did lack available virological results. This highlights the need for health authorities to make greater efforts to ensure access to necessary equipment for proper patient follow-up.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLimitations and strengths of the study\u003c/b\u003e \u003c/p\u003e \u003cp\u003eOur study's findings should be considered in light of several limitations. First, the WHOQOL-BREF instrument measures QoL in the two weeks preceding the interview, however, participants may have provided information from a broader time period. Second, the cross-sectional design of the study does not allow us to establish a causal link. Additionally, the stigma attached to the disease and the subjectivity of the dimensions may affect the reliability of the answers. Finally, the lack of virological and immunological assessments limited the power of the study and our ability to conduct further tests.\u003c/p\u003e \u003cp\u003eDespite these limitations, our study was the first to use the WHOQOL-HIV-BREF instrument to assess QoL in Mali. Our study was also large in scale, covering all main care sites for PLHIV in the Bamako district. Additionally, we used the WHOQOL-HIV-BREF instrument, which is specifically designed for HIV patients and has been proven to be cross-culturally valid. A qualitative study is needed to explore PLHIV's perceptions of their disease, the factors affecting their QoL, and ways to improve it.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePeople living with HIV in Bamako had a poor QoL, with low scores in all domains. The study identified several modifiable factors linked to this poor QoL such as low monthly income, body mass index, symptoms, comorbidities, opportunistic infections, and not adhering to antiretroviral treatment. To improve the QoL for PLHIV, health authorities and healthcare professionals must make a sustained effort to remove barriers to care and increase public awareness of effective HIV management.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAIDS\u0026nbsp; \u0026nbsp;\u0026nbsp;Acquired ImmunoDeficiency Syndrome\u003c/p\u003e\n\u003cp\u003eCESAC\u0026nbsp;Care, Support and Advice Center for People Living with HIV/AIDS\u003c/p\u003e\n\u003cp\u003eCNESS\u0026nbsp;Comit\u0026eacute; National d\u0026rsquo;Ethique pour la Sant\u0026eacute; et les Sciences de la vie\u003c/p\u003e\n\u003cp\u003eCSR\u0026eacute;f\u0026nbsp; \u0026nbsp;Centre de Sant\u0026eacute; de R\u0026eacute;f\u0026eacute;rence\u003c/p\u003e\n\u003cp\u003eHIV\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Human Immunodeficiency Virus\u003c/p\u003e\n\u003cp\u003eHRQoL\u0026nbsp;Health-Related Quality of Life\u003c/p\u003e\n\u003cp\u003eMSDS\u0026nbsp; \u0026nbsp;Minist\u0026egrave;re de la Sant\u0026eacute; et du D\u0026eacute;veloppement Social\u003c/p\u003e\n\u003cp\u003ePLHIV\u0026nbsp;\u0026nbsp;People Living with HIV/AIDS\u003c/p\u003e\n\u003cp\u003eQoL\u0026nbsp; \u0026nbsp; \u0026nbsp;Quality of Life\u003c/p\u003e\n\u003cp\u003eSD\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Standard Deviation\u003c/p\u003e\n\u003cp\u003eSDGs\u0026nbsp; \u0026nbsp;Sustainable Development Goals\u003c/p\u003e\n\u003cp\u003eUHC\u0026nbsp; \u0026nbsp;\u0026nbsp;University Hospital Center\u003c/p\u003e\n\u003cp\u003eUNAIDS\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Joint United Nations Programme on HIV/AIDS.\u003c/p\u003e\n\u003cp\u003eUSAC\u0026nbsp;\u0026nbsp;Care and Accompaniment Units\u003c/p\u003e\n\u003cp\u003eWHO\u0026nbsp;\u0026nbsp;World Health Organization\u003c/p\u003e\n\u003cp\u003eWHOQOL-HIV-BREF \u0026nbsp;World Health Organisation Quality of Live HIV-Bref\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAuthor contributions\u003c/p\u003e\n\u003cp\u003eThe contributions of each author to this manuscript are as follows: NT, AS, OS, SSD, CAC, SK and HD: contributed to the conception and designed the work. AS, AY, and AAT: contributed to the acquisition of the data. AS and AY: analyzed the data. KK, AS, NT, MTT, and ST: contributed to the interpretation of data. NT, AS: drafted the work. KK, MK, SD, ID, MTT, and OS: substantively revised the manuscript. All authors affirm that they have read and approved the submitted version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data and all materials used in this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was provided for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinki (https://www.wma.net/policies-post/wma-declaration-of-helsinki/). The study protocol was approved by the National Ethics Committee for Life Sciences and Health of Mali (CNESS) under number N\u0026deg;2023/135/MSDS-CNESS. Free and informed consent was obtained from participants prior to inclusion. \u0026nbsp;They received complete and accurate information, clearly communicated and fully understood, before giving their consent. Participants were informed about the study\u0026apos;s objectives, risks, and potential benefits. However, data was securely stored and maintained with strict confidentiality. After the survey completion, participants received advice on treatment compliance and psychological support. The survey was conducted in a private location, where participants could complete the questionnaire on their own or have it explained to them. Each participant was assigned an anonymous identifying number. They could withdraw from the survey at any time without consequences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of conflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors of this study declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank all the participants who agreed to take part in the study. We would also like to thank the healthcare providers at all study sites for their invaluable support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMegari K. Quality of Life in Chronic Disease Patients. Health Psychology Research [Internet]. 9 sept 2013 [cit\u0026eacute; 21 sept 2023];1(3). 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PLoS One. 26 ao\u0026ucirc;t 2015;10(8):e0135705. \u003c/li\u003e\n\u003cli\u003eFuster-RuizdeApodaca MJ, Lagu\u0026iacute;a A, Safreed-Harmon K, Lazarus JV, Cenoz S, del Amo J. Assessing quality of life in people with HIV in Spain: psychometric testing of the Spanish version of WHOQOL-HIV-BREF. Health Qual Life Outcomes. 19 ao\u0026ucirc;t 2019;17:144. \u003c/li\u003e\n\u003cli\u003eYang Z, Chen W, Chen W, Ma Q, Wang H, Jiang T, et al. Factors associated with voluntary HIV counseling and testing among young students engaging in casual sexual activity: a cross-sectional study from Eastern China. BMC Public Health. 22 avr 2024;24(1):1109. \u003c/li\u003e\n\u003cli\u003eKarkashadze E, Gates MA, Chkhartishvili N, DeHovitz J, Tsertsvadze T. Assessment of quality of life in people living with HIV in Georgia. Int J STD AIDS. juin 2017;28(7):672‑8. \u003c/li\u003e\n\u003cli\u003eBetancur MN, Lins L, Oliveira IR de, Brites C. 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Quality of life of HIV-infected persons in Croatia. Coll Antropol. d\u0026eacute;c 2006;30 Suppl 2:79‑84. \u003c/li\u003e\n\u003cli\u003eRodriguez-Penney AT, Iudicello JE, Riggs PK, Doyle K, Ellis RJ, Letendre SL, et al. Co-Morbidities in Persons Infected with HIV: Increased Burden with Older Age and Negative Effects on Health-Related Quality of Life. AIDS Patient Care STDS. janv 2013;27(1):5‑16. \u003c/li\u003e\n\u003cli\u003eTeeka JS, Mutai J, Kangogo M. Factors associated with opportunistic infections (OIs) among HIV/AIDS patients attending comprehensive care clinic (CCC) at Mbagathi District Hospital, Nairobi Kenya: a cross-sectional study. PAMJ-One Health [Internet]. 29 avr 2024 [cit\u0026eacute; 20 janv 2025];13(22). Disponible sur: https://www.one-health.panafrican-med-journal.com/content/article/13/22/full\u003c/li\u003e\n\u003cli\u003eWig N, Lekshmi R, Pal H, Ahuja V, Mittal C, Agarwal S. The impact of HIV/AIDS on the quality of life: a cross sectional study in north India. Indian journal of medical sciences [Internet]. janv 2006 [cit\u0026eacute; 4 sept 2023];60(1). Disponible sur: https://pubmed.ncbi.nlm.nih.gov/16444082/\u003c/li\u003e\n\u003cli\u003eJelsma J, Maclean E, Hughes J, Tinise X, Darder M. An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care. juill 2005;17(5):579‑88. \u003c/li\u003e\n\u003cli\u003eAlgaralleh A, Altwalbeh D, Al-Tarawneh F. Health-Related Quality of Life Among Persons Living with HIV/AIDS in Jordan: An Exploratory Study. HIV AIDS (Auckl). 11 d\u0026eacute;c 2020;12:897‑907. \u003c/li\u003e\n\u003cli\u003eAlkhasawneh E, McFarland W, Mandel J, Seshan V. Insight into Jordanian thinking about HIV: knowledge of Jordanian men and women about HIV prevention. J Assoc Nurses AIDS Care. 2014;25(1):e1-9. \u003c/li\u003e\n\u003cli\u003eGhiasvand H, Higgs P, Noroozi M, Ghaedamini Harouni G, Hemmat M, Ahounbar E, et al. Social and demographical determinants of quality of life in people who live with HIV/AIDS infection: evidence from a meta-analysis. Biodemography Soc Biol. 2020;65(1):57‑72. \u003c/li\u003e\n\u003cli\u003eDegroote S, Vogelaers D, Vandijck DM. What determines health-related quality of life among people living with HIV: an updated review of the literature. Arch Public Health. 17 nov 2014;72:40. \u003c/li\u003e\n\u003cli\u003eNobre N, Pereira M, Roine RP, Sintonen H, Sutinen J. Factors associated with the quality of life of people living with HIV in Finland. AIDS Care. ao\u0026ucirc;t 2017;29(8):1074‑8. \u003c/li\u003e\n\u003cli\u003eGeorge S, Bergin C, Clarke S, Courtney G, Codd MB. Health-related quality of life and associated factors in people with HIV: an Irish cohort study. Health Qual Life Outcomes. 5 ao\u0026ucirc;t 2016;14(1):115. \u003c/li\u003e\n\u003cli\u003eAhmad M, Al-Daken L, Ahmad H. Quality of Life for Patients in Medical-Surgical Wards. Clinical nursing research [Internet]. ao\u0026ucirc;t 2015 [cit\u0026eacute; 30 d\u0026eacute;c 2024];24(4). Disponible sur: https://pubmed.ncbi.nlm.nih.gov/24532669/\u003c/li\u003e\n\u003cli\u003eOrganisation Mondiale de la Sant\u0026eacute;. Principaux rep\u0026egrave;res sur le VIH/sida [Internet]. 2023 [cit\u0026eacute; 26 ao\u0026ucirc;t 2023]. Disponible sur: https://www.who.int/fr/news-room/fact-sheets/detail/hiv-aids\u003c/li\u003e\n\u003cli\u003eCSLS-TBH. Cellule sectorielle de lutte contre le VIH/SIDA la tuberculose et les hepatites virales. Rapport 2021. 2021. \u003c/li\u003e\n\u003cli\u003eJaquet A, Garanet F, Balestre E, Ekouevi DK, Azani JC, Bognounou R, et al. Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso. J Int AIDS Soc. 20 d\u0026eacute;c 2013;16(1):18867. \u003c/li\u003e\n\u003cli\u003eBajunirwe F, Tisch DJ, King CH, Arts EJ, Debanne SM, Sethi AK. Quality of life and social support among patients receiving antiretroviral therapy in Western Uganda. AIDS Care. mars 2009;21(3):271‑9. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable I: Sociodemographic of people living with HIV in Bamako in 2023 (N= 722)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"592\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSociodographic and clinical characteristis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 592px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge range \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Mean (SD) = 41.35 (0.45)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026le; 40 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e51.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026gt; 40 years old\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e49.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e409\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e56.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eSingle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eDivorcee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFormal Education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e383\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e53.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e47.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 592px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly income (CFA franc)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eLess than 100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e87.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eGreater than or equal to 100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e12.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e100,000 CFA franc =\u0026nbsp;165,44 $ US\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable II: Clinical characteristics of people living with HIV in Bamako in 2023\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 242px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody mass index (Kg\u003c/strong\u003e/m\u003csup\u003e2\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/sup\u003e\u003cstrong\u003e) (n= 722)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026ge; 18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 242px;\"\u003e\n \u003cp\u003e90.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026lt; 18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 242px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime elapsed since diagnosis (n= 694)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026le; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 242px;\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026gt; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e83.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of clinical symptoms (n= 722)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e34.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e65.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of clinical symptoms* (n= 249)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Cough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Common cold\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Headaches\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Low back sciatica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Abdominal pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Aching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Anorexia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Chill/fever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Vertigo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Constipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Edema of the lower limbs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Genital pruritus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Vomiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Dyspnea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Diarrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of comorbidity (n= 722)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e569\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e78.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of comorbidity* (n= 153)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Peptic ulcer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e50.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;High blood pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e34.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Others**\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of opportunistic diseases* (n= 722)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 48px;\"\u003e\n \u003cp\u003e569\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e78.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of opportunistic diseases (n= 153)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Non-TB bacterial pneumonias\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e71.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Oral and/or esophageal candidiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Urinary/genital infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Malaria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;Tuberculosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 242px;\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Each patient was presented with all/multiple options. ** Others: tumor (3), genital infection (3), Asthma (2), sickle cell disease (2), viral hepatitis (1), heart disease (1).\u003c/p\u003e\n\u003cp\u003eTable III: Therapeutic, virological and immunological characteristics of people living with HIV in Bamako in 2023 in the last 6 months\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"646\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment plan (n= 722)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003eTenofovir/Lamivudine/Dolitegravir\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e717\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e99.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003eTenofovir/Lamivudine/Efavirenz\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003eConcept of treatment discontinuation (n= 722)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e696\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e96.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003eType of HIV (n= 722)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;HIV-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e703\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e97.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;HIV-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;HIV-1\u0026amp;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvailability of viral load results (n= 722)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e293\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e40.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e59.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eViral load results (n = 293) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;Undetectable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e286\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;Detectable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCD4 rate availability (n = 722) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e697\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e96.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" colspan=\"3\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCD4 count result (cells/mm\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e) (n = 25) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026gt; 350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026le; 350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e100.0\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe Tenofovir, Lamivudine and Dolitegravir regimen is the standard HIV management protocol in Mali. We noted a lack of availability of follow-up paraclinical data for patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable IV: Inter-domain correlation matrix of the WHOQOL-HIV-BREF instrument\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomains\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003col\u003e\n \u003cli\u003eOverall perception of QoL\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eOverall perception of health\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.408*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003ePhysical health\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.422*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.501*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003ePsychological\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.701*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.456*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.590*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003eSocial relations\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.493*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.228*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.404*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.579*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003col start=\"6\"\u003e\n \u003cli\u003eEnvironment\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.613*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.356*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.510*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.707*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.547*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1,000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote: * = p\u0026lt;0.001\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe correlation matrix shows an adaptation of the WHOQOL-HIV-Bref tool in the Mali context.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable V: Mean scores and reliability coefficients of the WHOQOL-HIV-BREF domains among patients living with HIV in Bamako in 2023.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"606\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomains\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean scores \u0026plusmn; standard deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCronbach\u0026apos;s alpha if the element is deleted\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003ePhysical health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003e15,637 \u0026plusmn; 3,079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.797\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003ePsychological\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003e12,289 \u0026plusmn; 3,555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.749\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003eSocial relations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003e\u0026nbsp;12,929 \u0026plusmn; 3,560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.808\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003eEnvironment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003e11,717 \u0026plusmn; 2,893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.769\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003e9,718 \u0026plusmn; 5,476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.826\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe PLHIV in our study had a low average level of quality of life in all domains of quality of life.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable VI: Factors associated with global perception of QoL and health among PLHIV in Bamako 2023.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"991\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal perception of quality of life\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal perception of health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003ebrut\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eAdjusted\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003ebrut\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eAdjusted\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.336 [-0.548; -0.124]; \u003cstrong\u003e\u003cem\u003e0.002\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.014 [-0.196; 224]; \u003cem\u003e0.897\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.290 [-0.489; -0.090]; \u003cstrong\u003e\u003cem\u003e0.004\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.742 [-1.236; -0.248]; \u003cstrong\u003e\u003cem\u003e0.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.120 [-0.297; 0.057]; \u003cem\u003e0.184\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.051 [-0.129; 0.230]; 0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.059 [-0.226; 0.107]; \u003cem\u003e0.483\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.952 [-1.379; -0.525]; \u003cstrong\u003e\u0026lt;\u003cem\u003e0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.841 [-1.099;-0.582]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.600[-0.846; -0.355]; \u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.490 [-0.742; -0.251]; \u003cstrong\u003e\u0026lt;\u003cem\u003e0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.656 [-1.217; -0.095]; \u003cstrong\u003e\u003cem\u003e0.022\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSchooling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.580 [-0.752; -0.409]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.375 [-0.540; -0.209]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.293 [-0.457; 0.128]; \u003cstrong\u003e\u0026lt;\u003cem\u003e0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.424 [-0.812; -0.36]; \u003cstrong\u003e\u003cem\u003e0.032\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSingle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e- 0.050 [-0.253; 0.354]; \u003cem\u003e0.744\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.052[-0.341; 0.237]; \u003cem\u003e0.723\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.210 [-0.081; 0.502]; \u003cem\u003e0.158\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.068 [-0.750; 0.613]; \u003cem\u003e0.845\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eDivorcee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.646 [-0.977; 0.316]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.538[-0.854; -0.222]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.041[-0.359; 0.277]; \u003cem\u003e0.802\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.061 [-0.678; 0.800]; \u003cem\u003e0.872\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.588 [-0.790; -0.386]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.438[-0.643; -0.232]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.212[-0.406; 0.018]; \u003cstrong\u003e\u003cem\u003e0.032\u003c/em\u003e\u0026nbsp;\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.232 [-0.714; 0.250]; \u003cem\u003e0.345\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.596 [-0.897; -0.295]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.379[-0.643; -0.115]; \u003cstrong\u003e\u003cem\u003e0.005\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.596[-0.879; -0.314]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.674 [-1.324; -0.024]; \u003cstrong\u003e\u003cem\u003e0.042\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eStigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0, 860 [-1.620; -0.115]; \u003cstrong\u003e\u003cem\u003e0.024\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0, 185 [-0.936; 0.566]; \u003cem\u003e0.630\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.287 [-0.996; 0.422]; 0.428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.838 [-0.931; 2.607]; \u003cem\u003e0.353\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSymptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.768 [-0.945; -0.591]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.551[-0.724; -0.377]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.782 [-0.946; -0.617]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-2.597 [-3.005; -2.189]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eComorbidities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.356 [-0.977; 0.316]; \u003cstrong\u003e\u003cem\u003e\u0026lt;\u003c/em\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0, 182 [-0.381; -0.018]; \u003cem\u003e0.074\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.224[-0.426; -0.022]; \u003cstrong\u003e\u003cem\u003e0.030\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1.020 [-1.488; -0.552]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eOpportunists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.621 [-0.948; -0.295]; \u003cstrong\u003e\u003cem\u003e\u0026lt;\u003c/em\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0, 285 [-0.613; -0.044]; \u003cem\u003e0.089\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.760 [-1.064; -0.455]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.884 [-1.659; -0.108]; \u003cstrong\u003e\u003cem\u003e0.026\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eHIV duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.295 [-0.542; -0.048]; \u003cstrong\u003e\u003cem\u003e0.019\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.365 [-0.575; -0.155]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.477 [-0.708; -0.246]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.912 [-1.437; -0.387]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eARTnon-compliance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.257 [-0.498; -0.017]; \u003cstrong\u003e\u003cem\u003e0.036\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.226 [-0.448; -0.004]; \u003cstrong\u003e\u003cem\u003e0.046\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.373 [-0.597; -0.148]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.237 [-0.757; 0.284]; \u003cem\u003e0.373\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eViral load\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e0.581 [-0.325; 1.488]; \u003cem\u003e0.209\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.330 [-0.529; 1.189]; \u003cem\u003e0.451\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.860 [-0.018; 1.738]; \u003cstrong\u003e\u003cem\u003e0.055\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.710 [-0.154; 1.573]; \u003cem\u003e0.107\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eCD4 rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 207px;\"\u003e\n \u003cp\u003e-0.350 [-1.382; 0.682]; \u003cem\u003e0.506\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.426 [-0.665; 1.517]; \u003cem\u003e0.444\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.900 [-2.226; 0.426]; \u003cem\u003e0.184\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.633 [-1.941; 0.675]; \u003cem\u003e0.343\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eNote\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e: \u003cem\u003eGender [0= male; 1= female]; age [0= \u0026le; 40 years; 1 =\u0026nbsp;\u003c/em\u003e\u003cimg width=\"34\" height=\"11\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003cem\u003e]; monthly income [0=\u0026nbsp;\u003c/em\u003e\u003cimg width=\"40\" height=\"11\" src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAACgAAAALCAMAAAA6GD/HAAAAAXNSR0IArs4c6QAAAE5QTFRFAAAAAAAAAAA6OjpmOma2OpC2OpDbZjoAZjpmZrb/kDo6kDpmkGZmkJCQkLbbkNv/tmY6tpBmtv//25A627aQ/7Zm/9uQ/9u2//+2///b138J+gAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAADsQAAA7EAZUrDhsAAAAZdEVYdFNvZnR3YXJlAE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAaUlEQVQoU6WQwQ6AIAxDi6KCqCiIyv//qANjNHEX4g5vh3XNOqC8onHALBoe2W8fLHCMymGTsbcckiwu9ZQ7OQYNrznQfFVZdgl9EnIAgrzTFDnSecZxeN14dKLSlLpNqb94Upf/8+fGCTKHCgkgGkA7AAAAAElFTkSuQmCC\" alt=\"image\"\u003e\u003cem\u003e; 1= \u0026ge; 100000], Schooling [0= yes; 1= no]; marital status [0 = married, 1 = divorced, 2 = single, 3 = widowed], BMI [0=\u0026ge;18.5; 1=\u0026lt;18.5]; stigma [0=no; 1=Yes, symptom [0=no; 1=Yes]; comorbidities [0=no; 1=Yes]; opportunistic [0=no; 1=Yes]; HIV duration [0=\u0026ge;12 months, 1=\u0026lt;12 months]; non-adherence [0=no; 1=Yes]; VL [0=no; 1=Yes], CD4 [0=\u0026ge;350, 1=\u0026lt;350].\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eRef = 0\u003c/em\u003e\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eTable VII: Factors associated with physical and psychological health domains among PLHIV in Bamako in 2023.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"984\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 412px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 431px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePsychological\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003ebrut\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eAdjusted\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003ebrut\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eAdjusted\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.013 [-1.550; -0.477]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.698[-1.196; -0.200]; \u003cstrong\u003e\u003cem\u003e0.006\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1,705 [-2.318; -1.092]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.880 [-1.484; -0.277]; \u003cstrong\u003e\u003cem\u003e0.004\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.112 [-1.554; -0.671]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.809[-1.235;-0.383]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-0.220 [-0.739; 0.298]; 0.404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.003 [-0.519; 0.513]; \u003cem\u003e0.991\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eSchooling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.201 [-1.642; -0.760]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.423 [-0.816;-0.031]; \u003cstrong\u003e0.035\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.503 [-2.011; -0.996]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.855 [-1.331; -0.380]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eMonthly income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.245 [-1.897; -0.593]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.752 [-0.168;-1.336]; \u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-2.018 [-2.763; -1, 272]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-1.409 [-2.117; -0.702;]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eDivorce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.304 [-1.155; -0.548]; 0.485\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.058 [-0.692; 0.808]; 0.879\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1,810 [-2,784; -0.837]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-1.260 [-2.168; -0.351]; \u003cstrong\u003e\u003cem\u003e0.007\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.341 [-0.440; -1.123]; 0.392\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.148 [-0.834; 0.538]; 0.672\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-0.331 [-1.224; -0.563]; 0.468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.739 [-1.570; 0.091]; \u003cem\u003e0.081\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.226 [-1.746; -0.706]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.243 [-0.731; 0.246]; 0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1,730 [-2.324; -1.136]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-1.112 [-1.704; -0.521]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eSymptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-3.081 [-3.496; -2.666]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-2.674 [-3.086;-2.263]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-2,576 [-3.088;-2.065]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-1.937 [-2.435; -1.439]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eComorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.515 [-2.053; -0.977]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.927 [-1.400;-0.453]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.024 [-1.654; -0.394]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.431 [-1.005; 0.142]; \u003cem\u003e0.141\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eOpportunists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1,775 [-2.604; -0.946]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.019 [-1.798; -0.239]; \u003cstrong\u003e\u003cem\u003e0.010\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-2, 302 [-3.256; -1,348];\u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-1.290 [-2.234; -0.346]; \u003cstrong\u003e\u003cem\u003e0.007\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eStigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.859 [-2.778; -1.061]; 0.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.886 [-0.898; 2.669]; \u003cem\u003e0.330\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-2,626 [-4.835; -0.417]; \u003cstrong\u003e\u003cem\u003e0.020\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.009 [-2.169; 2.152]; \u003cem\u003e0.994\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eARTnon-ompliance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.288 [-0.901; -0.325]; 0.357\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.406 [-0.933; 0.121]; \u003cem\u003e0.131\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.041 [-1.746; -0.337]; \u003cstrong\u003e\u003cem\u003e0.004\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.931 [-1.569; -0.292]; \u003cstrong\u003e\u003cem\u003e0.004\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eTAR duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.903 [-1.508; -0.297]; \u003cstrong\u003e\u003cem\u003e0.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-0.873 [-1.550; -0.292]; \u003cstrong\u003e\u003cem\u003e0.002\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.236 [-1.933; -0.538]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e-0.903 [-1.508; -0.297]; \u003cstrong\u003e\u003cem\u003e0.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eViral load\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1.151 [-1.121; 3.423]; 0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.637 [-1.572; 2.847]; \u003cem\u003e0.572\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e2.850 [0.186; 5.515]; \u003cstrong\u003e\u003cem\u003e0.036\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e2.167 [-0.358; 4.693]; \u003cem\u003e0.093\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eCD4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e-1.135 [-3.969; -3,969]; 0.433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.352 [-2.273; 2.977]; \u003cem\u003e0.792\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.055 [-4.125; 2.015]; \u003cem\u003e0.501\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e0.200 [-2.867; 3.268]; \u003cem\u003e0.898\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eNote\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e: \u003cem\u003eGender [0= male; 1= female]; age [0= \u0026le; 40 years; 1 =\u0026nbsp;\u003c/em\u003e\u003cimg width=\"34\" height=\"11\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003cem\u003e]; monthly income [0=\u0026nbsp;\u003c/em\u003e\u003cimg width=\"40\" height=\"11\" src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAACgAAAALCAMAAAA6GD/HAAAAAXNSR0IArs4c6QAAAE5QTFRFAAAAAAAAAAA6OjpmOma2OpC2OpDbZjoAZjpmZrb/kDo6kDpmkGZmkJCQkLbbkNv/tmY6tpBmtv//25A627aQ/7Zm/9uQ/9u2//+2///b138J+gAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAADsQAAA7EAZUrDhsAAAAZdEVYdFNvZnR3YXJlAE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAaUlEQVQoU6WQwQ6AIAxDi6KCqCiIyv//qANjNHEX4g5vh3XNOqC8onHALBoe2W8fLHCMymGTsbcckiwu9ZQ7OQYNrznQfFVZdgl9EnIAgrzTFDnSecZxeN14dKLSlLpNqb94Upf/8+fGCTKHCgkgGkA7AAAAAElFTkSuQmCC\" alt=\"image\"\u003e\u003cem\u003e; 1= \u0026ge; 100000], Schooling [0= yes; 1= no]; marital status [0 = married, 1 = divorced, 2 = single, 3 = widowed], BMI [0=\u0026ge;18.5; 1=\u0026lt;18.5]; stigma [0=no; 1=Yes, symptom [0=no; 1=Yes]; comorbidities [0=no; 1=Yes]; opportunistic [0=no; 1=Yes]; HIV duration [0=\u0026ge;12 months, 1=\u0026lt;12 months]; non-adherence [0=no; 1=Yes]; VL [0=no; 1=Yes], CD4 [0=\u0026ge;350, 1=\u0026lt;350].\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eRef = 0\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable VIII: Factors associated with social and environmental domains among PLHIV in Bamako in 2023.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"1006\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial relations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEnvironment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003ebrut\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eAdjusted\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003ebrut\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eAdjusted\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e[ \u003csub\u003e95% CI\u0026nbsp;\u003c/sub\u003e] ; \u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1.467 [-2.084; -0.850]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.315 [-0.897; 0.267]; 0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.239 [-1.739; -0.738]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.280 [-0.757; 0.197]; 0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.872 [-1.387; 0.357]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.278 [-0.775; 0.220]; 0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-0.477 [-0.897; -0.056]; \u003cstrong\u003e\u003cem\u003e0.026\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e0.011 [-0.397; 0.419]; 0.957\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eSchooling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1.231 [-1.743; -0.719]; 0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.610 [-1.068; -0.151]; \u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.681 [-2.085; -1, 277]; 0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-1.100 [-1.476; -0.724]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1.305 [-2.060; -0.550]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e0.654 [-0.028; 1.336]; 0.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-2.191 [-2.789; -1.594]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-1.658 [-2.217; -1.099]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eDivorce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-4.691 [-5.567; -3.815]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-4.235 [-5.111; -3.359]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.665 [-2.440; -0.891]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-1.337 [-2.055; -0.619]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1.319 [-2.122; -0.515]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-1.588 [-2.389; -0.787]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e0.041 [-0.670; 0.752]; 0.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.299 [-0.955; 0.357]; 0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-3.377 [-3.911; -2.842]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-2.996 [-3.566; -2.426]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.918 [-2.390; -1, 445]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-1.373 [-1.840; -0.906]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eSymptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1,737 [-2,268; -1, 206]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-1.098 [-1.578; -0.617]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.894 [-2.316; -1.473]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-1.292 [-1.685; -0.898]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eComorbidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.968 [-1.599; -0.337]; \u003cstrong\u003e\u003cem\u003e0.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.204 [-0.757; 0.349]; 0.470\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.248 [-1.756; -0.740]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.731 [-1.184; -0.278]; \u003cstrong\u003e\u003cem\u003e0.002\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eOpportunists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-1.441 [-2.405; -0.477]; \u003cstrong\u003e\u003cem\u003e0.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.430 [-1.340; -0.481]; 0.355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.474 [-2.255; -0.693]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.655 [-1.401; 0.091]; 0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eStigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.924 [-1.125; -0.722]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-1.898 [-3.981; 0.185]; 0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.842 [-3.642; -0.043]; \u003cstrong\u003e\u003cem\u003e0.045\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.210 [-1.917; 1.497]; 0.809\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eARTnon-ompliance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.524 [-1.232; 0.184]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.637 [-1.252; -0.021]; \u003cstrong\u003e\u003cem\u003e0.043\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-0.811 [-1.384; -0.238]; \u003cstrong\u003e\u003cem\u003e0.006\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.848 [-1.353; -0.344]; \u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e-0.565 [-1.268; 0.138]; 0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.565 [-1.268; 0.138]; 0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-0.595 [-1.166; -0.024]; \u003cstrong\u003e\u003cem\u003e0.041\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.565 [-1.268; 0.138]; 0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eViral load\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e1.302 [-1.229; 3, 833]; 0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e-0.114 [-2.272; 2.045]; 0.918\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e2.618 [0.451; 4.785]; \u003cstrong\u003e\u003cem\u003e0.018\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e1.907 [-0.141; 3.955]; 0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eCD4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e0.015 [-3.704; 3, 734]; 0.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e1,469 [-1,291; 4,229]; 0,297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e-1.250 [-3.754; 1, 254]; 0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e-0.345 [-2.778; 2.088]; 0.781\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eNote\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e: \u003cem\u003eGender [0= male; 1= female]; age [0= \u0026le; 40 years; 1 =\u0026nbsp;\u003c/em\u003e\u003cimg width=\"34\" height=\"11\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003cem\u003e]; monthly income [0=\u0026nbsp;\u003c/em\u003e\u003cimg width=\"40\" height=\"11\" src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAACgAAAALCAMAAAA6GD/HAAAAAXNSR0IArs4c6QAAAE5QTFRFAAAAAAAAAAA6OjpmOma2OpC2OpDbZjoAZjpmZrb/kDo6kDpmkGZmkJCQkLbbkNv/tmY6tpBmtv//25A627aQ/7Zm/9uQ/9u2//+2///b138J+gAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAADsQAAA7EAZUrDhsAAAAZdEVYdFNvZnR3YXJlAE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAaUlEQVQoU6WQwQ6AIAxDi6KCqCiIyv//qANjNHEX4g5vh3XNOqC8onHALBoe2W8fLHCMymGTsbcckiwu9ZQ7OQYNrznQfFVZdgl9EnIAgrzTFDnSecZxeN14dKLSlLpNqb94Upf/8+fGCTKHCgkgGkA7AAAAAElFTkSuQmCC\" alt=\"image\"\u003e\u003cem\u003e; 1= \u0026ge; 100000], Schooling [0= yes; 1= no]; marital status [0 = married, 1 = divorced, 2 = single, 3 = widowed], BMI [0=\u0026ge;18.5; 1=\u0026lt;18.5]; stigma [0=no; 1=Yes, symptom [0=no; 1=Yes]; comorbidities [0=no; 1=Yes]; opportunistic [0=no; 1=Yes]; HIV duration [0=\u0026ge;12 months, 1=\u0026lt;12 months]; non-adherence [0=no; 1=Yes]; VL [0=no; 1=Yes], CD4 [0=\u0026ge;350, 1=\u0026lt;350].\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eRef = 0\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Factors, PLHIV, Antiretroviral, Quality of Life, Mali","lastPublishedDoi":"10.21203/rs.3.rs-6262015/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6262015/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHIV is a source of concern, profoundly affecting the quality of life (QoL) of those affected. This study aimed to identify factors associated with the QoL of people living with HIV/AIDS (PLHIV) in Bamako in 2023.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A cross-sectional study including 722 PLHIV was conducted in Bamako from January to September 2023. Data on sociodemographic, clinical and therapeutic characteristics were collected. The WHOQOL-HIV-BREF instrument was used to assess domains in patients' quality of life. Linear regression was performed using SPSS25 software, with a significant level of 5%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean age of study population was 41.35 (SD = 0.45) years, and women represented 78%. PLHIV reported a diminished QoL, with an overall score of 9.718. Domain-specific scores were as follow: physical health (15.637); psychological health (12.289); social relations (12.929); and environment (11.717). A diminished QoL was associated with being female, older age, having a low monthly income, being divorced or widowed, and not having formal education. Clinical and paraclinical factors such as low body mass index, presence of symptoms, comorbidities, opportunistic infections, and therapeutic factors such as non-adherence to treatment were also linked with poor QoL.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePeople living with HIV in Bamako had poor QoL, with low scores in all domains. Several modifiable factors linked to this poor QoL such as low monthly income, body mass index, symptoms, comorbidities, opportunistic infections, and not adhering to antiretroviral treatment were identified. Efforts to improve care access, reduce socio-economic barriers, and increase public awareness of effective HIV/AIDS treatments are critical in improving the QoL for those living with HIV/AIDS.\u003c/p\u003e","manuscriptTitle":"Factors Associated with Quality of Life among People Living with HIV/AIDS in Mali, 2023","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-15 11:27:20","doi":"10.21203/rs.3.rs-6262015/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision 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11:27:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6262015","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6262015","identity":"rs-6262015","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}