Looking Beyond Health-Related Quality of Life: Predictors of Subjective Well-Being among People Living with HIV in the Netherlands.

Abstract

Health care interventions are increasingly expected to improve subjective well-being (SWB) rather than health-related quality of life (HRQOL) only. However, little is known about how HRQOL and other relevant quality of life (QOL) domains relate to SWB among people living with HIV. People living with HIV treated in Dutch HIV centers (n=191) completed a cross-sectional survey on SWB, HRQOL, and other QOL domains (social, financial, sexual, and environmental well-being). In bivariate analyses, all QOL domains were significantly related to SWB (r=.17 to .42). In structural equation models, physical health (β=.14; p<.05), mental health (β=.27; p<.01), and environmental well-being (β=.41; p<.01) directly predicted SWB, while financial and social well-being explained SWB indirectly. Thus, environmental well-being and mental health are the main predictors of SWB, and physical health, social well-being, and financial well-being to a lesser extent. Given that most of HIV-care is directed at improving physical health, from the perspective of promoting SWB HIV care should also be directed at other life domains.