An extension of the UNAIDS 90-90-90 target proposes >90% of people living with HIV (PLHIV) should have good health-related quality of life (HrQoL); however, limited guidance exists. The "Health Goals for Me" framework, an individualized approach to HIV care, provides a framework to assess HrQoL. We analyzed several patient-reported outcome measures (PROMs) to develop a practical toolkit to facilitate shared physician-patient decision-making. HrQoL subdomains, actionable in the clinical setting and measurable as PROMs, were selected. PROMs were collated through systematic literature searches, scored by the authors on usability, validation, and availability, after which practical recommendations were made. Nine subdomains were selected across physical, psychological, social, and environmental domains; 46 validated PROMs were identified. After pre-screening, from 39 evaluated PROMs, we recommended PROMs in the following subdomains: fatigue/energy loss, frailty/resilience, sleep disturbance, substance use, anxiety/depression, cognition, sexual function and desire, and stigma. Using this toolkit, healthcare professionals and PLHIV can collaborate and mutually agree on individual care objectives. Following the "Health Goals for Me" framework, appropriate care interventions can be implemented and reviewed in a continuous cycle. We discussed how eHealth interventions, which will have increasing importance in the post-COVID era, can facilitate improved HrQoL for PLHIV by utilizing toolkits such as the one described here. Implementation of this practical framework and the PROMs toolkit could provide a useful approach to assessing HrQoL in PLHIV and could enhance the physician's ability to gain valuable insights into the patient's daily life across a broad range of HrQoL issues.

中文翻译：

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“Moving Fourth”：为共同决策引入实用工具包，以促进超越 HIV 病毒抑制的健康生活。

联合国艾滋病规划署 90-90-90 目标的扩展建议 > 90% 的艾滋病毒感染者 (PLHIV) 应具有良好的健康相关生活质量 (HrQoL)；但是，存在有限的指导。“我的健康目标”框架是一种个性化的 HIV 护理方法，提供了一个评估 HrQoL 的框架。我们分析了几种患者报告的结果测量 (PROM)，以开发一个实用的工具包，以促进共享的医患决策。选择了 HrQoL 子域，可在临床环境中操作并作为 PROM 进行测量。PROM 是通过系统的文献搜索进行整理的，作者对可用性、验证和可用性进行评分，然后提出实用的建议。在物理、心理、社会和环境领域选择了九个子领域；确定了 46 个经过验证的 PROM。经过预筛选，从 39 个评估的 PROM 中，我们推荐了以下子领域的 PROM：疲劳/能量损失、虚弱/恢复力、睡眠障碍、物质使用、焦虑/抑郁、认知、性功能和性欲以及污名。使用此工具包，医疗保健专业人员和 PLHIV 可以合作并就个人护理目标达成一致。遵循“我的健康目标”框架，可以连续循环实施和审查适当的护理干预措施。我们讨论了电子卫生干预措施（在后 COVID 时代将变得越来越重要）如何通过利用此处描述的工具包来促进 PLHIV 的 HrQoL 改善。