Provider, researcher, and community perspectives on comorbidities affecting the health-related quality of life of people living with HIV in Spain

Sep 22, 2026

Comorbidities negatively affect the health-related quality of life (HRQoL) of people living with HIV (PLHIV) by increasing symptom burden, reducing functional and cognitive capacity, elevating psychological distress, and undermining adherence to treatment, which may contribute to poor viral suppression and complications. The study identified comorbidities and contextual determinants relevant to HRQoL and long-term well-being that could be monitored in routine Spanish care. Seven online focus groups with 115 participants prioritized diabetes, cardiovascular, neurologic, substance use, bone, renal, liver, cancers, mental health, and pulmonary conditions.

LanguageEnglish

CategoryResearch & Report

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Pages12

Reading Time30 min

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Abstract

Background

Methods

Results

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White et al. BMC Public Health (2026) 26:1534 BMC Public Health [https://doi.org/10.1186/s12889-026-26971-8](https://doi.org/10.1186/s12889-026-26971-8) RESEARCH Open Access Provider, researcher, and community perspectives on comorbidities affecting the health-related quality of life of people living with HIV in Spain Trenton M. White 1,2,3*, Carlos Prats-Silvestre4, Lena van Selm1,2, Carlos Iniesta4,5, Maria J. Fuster-RuizdeApodaca4,6 and Jeffrey V. Lazarus 1,2,3 Abstract Background Comorbidities, such as cardiovascular disease, diabetes, kidney disease, liver disease, and mental health issues, negatively impact the health-related quality of life (HRQoL) of people living with HIV (PLHIV) . Comorbidities can increase the symptom burden, reduce functional or cognitive capacity, increase psychological distress, and reduce adherence to treatment, which can lead to poor viral suppression and other complications. Methods This study aimed to identify and explore comorbidities and related contextual determinants of HRQoLand long-term well-being in PLHIV that could be monitored in routine care in Spain. Seven online focus groups were conducted with 115 participants consisting of members of community advocacy organizations (n = 33, 29%), HIV care providers (n = 78, 68%) and researchers (n = 4, 3%) in seven autonomous communities in Spain with the highest incidence of HIV. Results Focus group results revealed a prioritised list of comorbidities to monitor: diabetes, cardiovascular diseases, neurologic diseases, substance use problems, bone diseases, renal diseases, liver diseases, including metabolic dysfunction-associated steatotic liver disease, cancers and neoplasms, mental health problems, and pulmonary diseases. Conclusions This study emphasises the impact of comorbidities on PLHIV in Spain and the need for a comprehensive approach to HIV care that addresses comorbidities, including mental health. These data can inform the development of policies and interventions to reduce multimorbidity burden among PLHIV. Keywords Multimorbidity, HIV, Prevention, Integrated care, Spain *Correspondence: Trenton M. White [trenton.white@isglobal.org](trenton.white@isglobal.org) 1Barcelona Institute for Global Health (SGlobal), Calle del Rossellón, 132, 6-4, Barcelona ES-08036, Spain 2Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain 3The City University of New York (CUNY) Graduate School of Public Health and Policy, New York City, USA 4The Spanish Interdisciplinary AIDS Society (SEISIDA), Madrid, Spain 5CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain 6Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/licenses/by-nc-nd/4.0/](vecommons.org/licenses/by-nc-nd/4.0/.)[.](vecommons.org/licenses/by-nc-nd/4.0/.) White et al. BMC Public Health (2026) 26:1534 Background Since the

FAQs

What comorbidities did participants prioritize for monitoring?

Diabetes, cardiovascular diseases, neurologic diseases, substance use problems, bone diseases, renal diseases, liver diseases (including metabolic dysfunction-associated steatotic liver disease), cancers and neoplasms, mental health problems, and pulmonary diseases.

What was the main purpose of the study?

To identify and explore comorbidities and related contextual determinants of HRQoL and long-term well-being in PLHIV that could be monitored in routine care in Spain.

Who took part in the focus groups and how many participants were included?

Seven online focus groups included 115 participants: community advocacy organization members (n=33), HIV care providers (n=78), and researchers (n=4).

Sep 22, 2026

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