Aim
The study assessed the physical, psychological, social and environmental aspects of people living with HIV & AIDS (PLWHA) in Lesotho to determine the quality of life (QoL) aspects which need interventions.

Background
Determination of QoL of PLWHA is important to assess the impact of HIV & AIDS intervention programmes. Data on QoL of PLWHA in Lesotho are scarce.

Materials and methods
This was a cross-sectional descriptive study based on the World Health Organization QoL Brief (WHOQoL-Bref) questionnaire distributed to PLWHA in Maseru, Lesotho. Differences between QoL mean scores by clinical and socio-demographic variables were tested using analysis of variance (ANOVA).

Results
Of the 500 questionnaires distributed, 460 were returned with data acceptable for analysis. PLWHA were least satisfied with the physical domain followed by the environmental domain. In the physical domain, age (p = 0.01), level of education (p = 0.01), marital status (p = 0.02), employment status (p = 0.04) and social support (p < 0.001) significantly determined QoL. In the environmental domain, level of education (p = 0.001), employment status (p < 0.001), marital status (p = 0.031), social support (p < 0.001) and type of housing (p = 0.035) significantly determined QoL. However, CD4 counts, body mass index, number and type of dependents, and source of water were not significant variables determining QoL.

Conclusion
PLWHA in Lesotho are least satisfied with the physical and environmental aspects of their lives. Their QoL is determined by age, level of education, marital status, economic status and level of social support. Lesotho needs to scale up the implementation of social protection policy to improve QoL of PLWHA.