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HIV Care Engagement and Quality of Life Among People Living with HIV

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Infectious Diseases, Chronic Diseases, and Disease Prevention".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 2249

Special Issue Editor

Dr. Chadwick K. Campbell

E-Mail Website
Guest Editor
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA 92093, USA
Interests: HIV care engagement; HIV stigma; intersectionality; intersectional stigma; sexual and gender minorities; medication adherence; social determinants of health; mental health; substance use; ethnic and racial disparities

Special Issue Information

Dear Colleagues,

Over the past four decades, advances in biomedical treatment of HIV have shifted HIV from a terminal diagnosis to a livable and treatable chronic illness, allowing people living with HIV to live fuller, healthier lives. In spite of these achievements, there are racial, ethnic, gender, and geographic disparities in healthcare access, HIV care engagement, medication adherence, viral suppression, and quality of life. Biobehavioral, community, and structural interventions and strategies are needed to achieve equity in HIV care outcomes and quality of life, particularly among the most marginalized members of society. Racism, sexism, economic oppression, transphobia, homophobia and heterosexism, HIV stigma, and their intersections continue to influence the health outcomes and the overall well-being and lived experiences of people living with HIV. This Special Issue welcomes qualitative, quantitative, and mixed-methods research and literature reviews focused on HIV care engagement and quality of life among people living with HIV, as well as the influencing socio-structural factors. Papers focused on marginalized populations from a range of regional contexts globally are welcome.  

Dr. Chadwick K. Campbell
Guest Editor

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Keywords

  • quality of life
  • HIV care engagement
  • ART adherence
  • HIV stigma
  • intersectionality
  • intersectional stigma
  • social and structural determinants
  • HIV clinical outcomes
  • long-acting injectable ART

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Published Papers (3 papers)

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Research

13 pages, 514 KB  
Article
Prolonged Exposure to Antiretroviral Therapy and Risk of Developing Hypertension Among HIV-Infected Clinic Attendees: A Pilot Study in Rural Eastern Cape Province, South Africa
by Teke Apalata, Urgent Tsuro and Olufunmilayo Olukemi Akapo
Int. J. Environ. Res. Public Health 2025, 22(9), 1397; https://doi.org/10.3390/ijerph22091397 - 7 Sep 2025
Abstract
Antiretroviral therapy (ART) has significantly improved outcomes in individuals with human immunodeficiency virus (HIV), yet its long-term cardiovascular effects, especially on hypertension risk, remain debated. This pilot study investigated hypertension risk factors in HIV-positive patients undergoing ART and aimed at hypothesis generation rather [...] Read more.
Antiretroviral therapy (ART) has significantly improved outcomes in individuals with human immunodeficiency virus (HIV), yet its long-term cardiovascular effects, especially on hypertension risk, remain debated. This pilot study investigated hypertension risk factors in HIV-positive patients undergoing ART and aimed at hypothesis generation rather than drawing definitive causal conclusions. Seventy HIV-infected adults without baseline hypertension were enrolled and followed. Hypertension was defined using the 2017 ACC/AHA guidelines by the South African Hypertension Society. Data on demographic, anthropometric, metabolic, inflammatory, coagulation, and HIV-related variables were collected. Cox regression analysis identified independent predictors of hypertension. Participants had a median age of 37 years (IOR = 10.96), with 84.3% being female. After a median ART exposure of 61.01 months (range: 2–164), 27 individuals (38.6%) developed high blood pressure. In multivariable Cox models adjusting for metabolic syndrome and BMI, age ≥ 35 years was associated with a 2.2-fold higher hypertension risk (Hazard Ratio [HR]: 2.2; 95% Confidence Interval [CI]: 1.04–4.55; p = 0.04). Elevated triglycerides significantly increased risk, with a 7.9-fold higher likelihood of hypertension (HR: 7.9; 95% CI: 1.04–59.5; p = 0.046). ART regimen type, whether initial or current, did not independently predict hypertension. In conclusion, hypertension is prevalent during ART. We hypothesized that traditional cardiovascular risk factors, notably age ≥35 years and hypertriglyceridemia, were key independent predictors, emphasizing the need for routine cardiovascular risk assessment in HIV management. Full article
(This article belongs to the Special Issue HIV Care Engagement and Quality of Life Among People Living with HIV)
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16 pages, 275 KB  
Article
Positive Influences: How Provider Actions Affect HIV Care Engagement for Black Women in the Southwest U.S.
by Kenja S. Hassan, David W. Coon, Johannah Uriri-Glover and Marianne McCarthy
Int. J. Environ. Res. Public Health 2025, 22(9), 1319; https://doi.org/10.3390/ijerph22091319 - 25 Aug 2025
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Abstract
Despite medical advances having made HIV a survivable condition, HIV persists as the 11th leading cause of death among young Black women. Enhancing the quality of care engagement through beneficial patient–provider relationships can close gaps in retention and adherence, enabling long, healthy lives. [...] Read more.
Despite medical advances having made HIV a survivable condition, HIV persists as the 11th leading cause of death among young Black women. Enhancing the quality of care engagement through beneficial patient–provider relationships can close gaps in retention and adherence, enabling long, healthy lives. Using constructivist grounded theory informed by an established framework for patient-centered care in complex cancer settings and insight from local HIV advocates, this work identifies what provider actions retain women in care and why. Through focus groups and interviews, eleven Black women in the Southwestern United States, an understudied population, express that providers who engage them as co-creators in maintaining good health are more likely to retain them. Concurrently, when women are attuned to their own health care and interpersonal needs, they discern which providers are equally committed to their health based upon observed provider actions. These actions, such as listening attentively, taking time, and paying attention to the whole person, in conjunction with women’s motivation and active involvement, create a reciprocal dynamic that increases the likelihood these women will remain virally suppressed. The ideal relationship is one in which the provider empowers and champions women as drivers of their own care. Full article
(This article belongs to the Special Issue HIV Care Engagement and Quality of Life Among People Living with HIV)
13 pages, 269 KB  
Article
COVID-19 and the Syndemic of Intimate Partner Violence, Mental Health, Substance Use, and HIV Care Engagement Among Black Sexual Minority Men Living with HIV in the US South
by Carrie L. Nacht, Hannah E. Reynolds, Chadwick K. Campbell, Kirstin Kielhold, Wilson Vincent, Daniel E. Siconolfi, Susan M. Kegeles and Erik D. Storholm
Int. J. Environ. Res. Public Health 2025, 22(7), 1065; https://doi.org/10.3390/ijerph22071065 - 3 Jul 2025
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Abstract
Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance [...] Read more.
Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness. Full article
(This article belongs to the Special Issue HIV Care Engagement and Quality of Life Among People Living with HIV)
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