Depression, Medication Adherence, and Beliefs as Determinants of Health-Related Quality of Life among People Living with HIV: A Cross-Sectional Pharmacoepidemiologic Study in Indonesia

Abstract

Objective To examine the associations of depression, medication adherence, and medication beliefs with HRQoL among people living with HIV (PLWH) in primary healthcare (PHC) settings in Indonesia. Methods This cross-sectional study included PLWH attending 6 PHCs in Makassar (July-September 2025). HRQoL was assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L); depression using the Patient Health Questionnaire-9 (PHQ-9); adherence using the Medication Adherence Report Scale (MARS); and beliefs using the Beliefs about Medicines Questionnaire (BMQ). Multivariable linear regression examined associations with HRQoL. Results Among 400 participants (median age 30 years, interquartile range: 11), mean EQ-5D-5L utility was 0.94 ± 0.10. Higher depression severity was associated with lower HRQoL (β=−0.006; P < .001), while adherence and beliefs were not significant after adjustment. Conclusion Depression was the only independent psychosocial predictor of HRQoL, highlighting the need for integrated mental health support in HIV care within PHC settings.

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