Assessment of Health-Related Quality of Life in Adults Living with HIV Attending Antiretroviral Clinics versus Traditional Healers' Offices in Bukavu City, Democratic Republic of the Congo.

Background: The benefits of antiretroviral therapy (ART) for people living with HIV/AIDS (PLHIV) include immune system strengthening, viral load suppression, and improved health-related quality of life (HRQOL). This present study compares the HRQOL of PLHIV visiting ART clinics versus that of PLHIV attending traditional healers (THs)' offices, assesses the adherence of PLHIV to ART, identifies possible predictors of nonadherence of PLHIV to ART and HRQOL, and estimates the proportion of patients with HIV referred by THs to health centers in Bukavu.

Patients and methods: Between February and June 2023, a cross-sectional comparative study was conducted on 150 adult PLHIV attending ART clinics and 150 adult PLHIV visiting THs' offices in the 3 urban health zones of Bukavu. The World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and a self-report questionnaire measuring ART adherence were used to collect the data. Regression models were used to identify the predictors of no adherence to ART and the HRQOL of PLHIV.

Results: Compared with those attending THs, PLHIV attending ART clinics had higher mean scores in all HRQOL domains. Approximately 84% of the participants were compliant with ART. The predictors associated with nonadherence to ART included illiterate participants [OR=23.3 (95% CI=1.23-439.5), p=0.004] and divorced or separated participants [OR=10.3 (95% CI=1.12-94.4), p=0.034]. The proportion of PLHIV referred to ART clinics by THs was only 10.7%.

Conclusion: PLHIV visiting ART clinics had a better HRQOL than did PLHIV attending THs' offices. The rate of adherence to ART among PLHIV who attended ART clinics was high. It is recommended that PLHIV visiting THs be referred to ART clinics for improved HRQOL.