Abstract Background: Human Immunodeficiency Virus (HIV) pandemic is a major public health problem globally. People living with HIV/AIDS (PLWHA) now live longer. But they are confronted with many challenges that affect their health-related QOL. Objective: The study aimed at assessing the Health-related quality of life and associated factors among PLWHA on ART at Mettu Karl Specialized Hospital, southwest Ethiopia, 2019. Methods: A facility-based cross-sectional study was conducted from April to May 2019 among 310 randomly selected participants. An interviewer-administered structured questionnaire was used to collect the data. World Health Organization Quality of Life-HIV Brief Version was used to collect the HRQOL data. A logistic regression model was fitted to identify factors associated with health-related quality. Result: Nearly half (46.1%) of the respondents had poor overall HRQOL with mean ±SD 14.60 ± 2.79. Age (AOR= 1.85, 95% CI (1.08, 3.36)), residence (AOR= 1.86, 95% CI (1.15, 2.99)), functional status at initiation of ART (AOR= 1.73, 95% CI (1.04, 2.88)) treatment regimen (AOR= 2.00, 95% CI (1.24, 3.25)) were independent predictors of overall HRQOL. Duration of knowing status was independent predictor of physical domain (AOR=1.78, 95% CI (1.12, 2.83)). Educational status predicted the psychological domain (AOR=0.51, 95%CI (0.30, 0.87)) and spiritual-related domain (AOR=1.90; 95%CI (1.14, 3.16)). Functional status at the start of ART independently predicted the social support domain (AOR=1.82, 95%CI (1.08, 3.05)). Gender (AOR=2.35, 95%CI (1.44, 3.82)) and WHO clinical stage at the start of ART (AOR=2.79, 95%CI (1.34, 5.80)) were independent predictors of environmental domain. Opportunistic infection was independent predictor of spiritual-related domain (AOR=1.91, 95%CI (1.11, 3.27)). Conclusion: This study showed that the overall HRQOL among the study participants was poor. Age, residents, functional status, and ART regimen were determinants of overall HRQOL. Therefore, health providers should use the determinants in assessing HRQOL of PLWHA to facilitate all rounded management of HIV.
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