{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:01:22Z","timestamp":1789524082220,"version":"build-2803163510"},"reference-count":59,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T00:00:00Z","timestamp":1667520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Next to monitoring the clinical health of people living with HIV through the triple 90 targets, a 4th 90 target was proposed in 2016 to improve HIV health\u2010related quality of life (HrQoL) by addressing comorbidities and other psychosocial challenges. This scoping review aimed at understanding related psychosocial determinants, including strategies to improve HrQoL for people living with HIV in sub\u2010Saharan Africa (SSA), as an initiative to ameliorate the continuum of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This scoping review followed PRISMA guidelines. We searched PubMed and Wiley databases from 01 January 2011 to 19 April 2021 for articles on HrQoL, including determinants and related interventions in SSA. We also conducted a manual search to retrieve grey literature on the \u20184th 90\u2019 target. The six domains of HrQoL defined in the most widely used instrument (i.e., WHOQOL\u2010HIV\u2010BREF tool) served as a guiding framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three articles were included for analysis. Seven articles illustrated the ongoing debate on the 4th 90 target, highlighting challenges with measuring indicators. Nine articles discussed HrQoL domains, reporting the highest scores in the spirituality and physical domains and lowest scores in the social and environmental domains. The presence of stigma and depressive symptoms was associated with low HrQoL. Seventeen articles discussed HrQoL interventions, highlighting that improved HrQoL enhanced health\u2010seeking behaviour. Only two interventions addressed the environmental domain highlighting the fact that selection of intervention aims were not evidence led.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Introducing the 4th 90 target in SSA as a strategy to enhance HrQoL amongst people living with HIV could improve the HIV continuum of care; however, efforts are required to effectively address environmental and structural determinants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13825","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T07:59:11Z","timestamp":1666339151000},"page":"1026-1043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The \u20184th 90\u2019 target as a strategy to improve health\u2010related quality of life of people living with <scp>HIV<\/scp> in <scp>sub\u2010Saharan<\/scp> Africa"],"prefix":"10.1111","volume":"27","author":[{"given":"Prudence Tatiana Nti","family":"Mvilongo","sequence":"first","affiliation":[{"name":"Global Health Systems Solutions  Douala Cameroon"},{"name":"Department of Public Health, Sexual and Reproductive Health Research Group Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jef","family":"Vanhamel","sequence":"additional","affiliation":[{"name":"Department of Public Health, Sexual and Reproductive Health Research Group Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Public Health, Sexual and Reproductive Health Research Group Institute of Tropical Medicine  Antwerp Belgium"},{"name":"Department of Clinical and Health Psychology, Faculty of Psychology University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana","family":"N\u00f6stlinger","sequence":"additional","affiliation":[{"name":"Department of Public Health, Sexual and Reproductive Health Research Group Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,4]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"UNAIDS.UNAIDS Goal 90\u201090\u201090: an ambitious treatment target to help end the AIDS epidemic. 2014; 40. 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