Beyond Viral Suppression: Quality of Life Among People Living With HIV in Czechia

Background

Effective antiretroviral therapy has enabled many countries to approach the 95–95–95 HIV targets, but viral suppression alone does not ensure good health-related quality of life (HRQoL). In Czechia, systematic HRQoL data among people living with HIV (PLHIV) have been lacking. This study provides a national baseline for future monitoring within the National HIV/AIDS Program 2023–2027.

Methods

We conducted the first Czech nationwide cross-sectional study among adults living with HIV monitored in ten specialized HIV centers. Data were collected online and on paper between September and November 2025 in Czech and Ukrainian, reflecting that Ukrainians are now the largest migrant minority in Czechia. HRQoL was measured using PozQoL, alongside PHQ-9, GAD-7, and perceived social support. Analyses included descriptive statistics, reliability testing, group comparisons, and Spearman correlations.

Results

The sample included 594 PLHIV: 466 completed the Czech and 128 the Ukrainian questionnaire. PozQoL showed excellent internal consistency in the Czech sample (Cronbach’s α = 0.89). Mean HRQoL did not differ significantly between Czech and Ukrainian respondents (3.56 vs 3.60). However, 18.5% of Czech and 19.5% of Ukrainian respondents reported low HRQoL, while almost half reported moderate HRQoL. In the Czech sample, women had lower HRQoL than men (3.27 vs 3.59; p < 0.05; Cohen’s d = 0.47). HRQoL correlated negatively with anxiety (rho=-0.55) and depressive symptoms (rho=-0.60), and positively with social support (rho=0.50).

Conclusions

Our research shows that HIV care in Czechia cannot be evaluated solely by biomedical indicators. Around one in five PLHIV reported low HRQoL, indicating unmet psychosocial and structural needs. Public health action should combine routine HRQoL monitoring, mental health and peer support, and HIV destigmatization in healthcare, institutions, and society. Future research should examine stigma, migration and gender as HRQoL determinants.

Key messages

• One in five people living with HIV in Czechia reported low quality of life, despite access to effective HIV treatment.

• Improving HIV outcomes requires HRQoL monitoring, mental health support, and destigmatization across institutions and society.