Literature on health-related quality of life (HRQOL) has focused on people living with chronic conditions, with less attention given to HRQOL among informal caregivers. We used cross-sectional dyadic data from both care recipients (CR) living with HIV and the person they identified as their primary informal (unpaid) caregiver (CG) to identify psychosocial and caregiving relationship factors (including, CG role ambivalence and caregiving-related stress) associated with CG HRQOL. We conducted confirmatory factor analysis and structural equation modeling testing. The results highlight interdependent effects of the CG-CR relationship and reveal pathways whereby relationship interactions positively and negatively impact CGs’ HRQOL. Affiliative stigma, CG-CR communication, CRs’ reciprocity of support and other psychosocial factors indirectly and differentially affected physical and mental HRQOL through effects on secondary stress and role ambivalence. Dyad-focused intervention on interpersonal communication and support exchange may improve HRQOL and resilience of CGs of vulnerable people living with HIV.

关于健康相关生活质量 (HRQOL) 的文献主要关注慢性病患者，而对非正式护理人员的 HRQOL 关注较少。我们使用来自艾滋病毒感染者（CR）和他们确定的主要非正式（无偿）护理人员（CG）的横截面二元数据来确定心理社会和护理关系因素（包括CG角色矛盾和护理相关）压力）与 CG HRQOL 相关。我们进行了验证性因素分析和结构方程模型测试。结果强调了 CG-CR 关系的相互依存效应，并揭示了关系相互作用对 CG 的 HRQOL 产生积极和消极影响的途径。隶属耻辱、CG-CR 沟通、CR 的相互支持和其他心理社会因素通过对继发压力和角色矛盾心理的影响，间接且不同地影响身心 HRQOL。以二元为重点的人际沟通和支持交流干预措施可能会改善艾滋病毒感染者弱势群体的 HRQOL 和 CG 的复原力。