Resilience and social support in HIV/AIDS clients at the HIV Netherlands Australia Thailand Research Collaboration, Thai Red Cross AIDS Research Centre.

Abstract

Background : By 2015, Thailand had accumulated amount of 1,201,839 HIV infected people and approximately 600,000 HIV-infected patients were expected alive. Although relevant agencies have been trying to reduce discrimination and stigmatization, however, only 355,123 HIV-infected patients have been treated under the National Health System. The lower uptake of treatment in National Health system may be partly due to the stigma and discrimination. Many studies have found that social support and resilience can reduce the impact of stigmatization and discrimination. Additionally, it is also contributed to the quality of life of people living with HIV.

Objective : This study aimed to evaluate the resilience and social support among HIV/ AIDS clients at the HIV Netherlands Australia Thailand Research Collaboration Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

Methods : This study was approved by the Institutional Review Board (IRB) at Chulalongkorn University and all clients gave their written consent prior entry to the study. The 3 self-report questionnaires (Demographic data form, Thai Resilience Scale by Wagnlid and Young, and Social support Questionnaire were administered during their visits from October to December 2016. Low, moderate and high level of resilience were defined as a score of <121, 121 - 146, 147 - 175 respectively. Low, moderate and high level of social support were defined as a score of 20 - 46, 47 - 73, 74 respectively. The resilience scale was presented as proportion and percentage. The associated factors of resilience and social support of HIV/AIDS clients were analysed by Chi-square test, Pearson’s correlation. Statistical analysis was performed by IBM SPSS Statistics version 22.0. P <0.05 was used for statistically significant.

Results : One hundred and thirty HIV clients participated in this study. The median age was 43 (IQR: 36 - 49) years. Most of the participants are male (69% males vs. 31% female). Almost 47% of them were single and 43% reported bachelor degree education. Approximately 26% of them had monthly income 5,000 - 10,000 Baht All of them received antiretroviral therapy with the median duration of HIV treatment was 11.3 (IQR 5 - 16.6) years. Almost two-third (72%) of them had current CD4 cell count more than five-hundred cells/mm3. Median CD4 was 608.5 (IQR 484 - 782) cells/ mm3. Ninety-nine percent had viral suppressed (HIV RNA <50 copies/ml). Fifty-five percent had high level of resilience (mean = 142.2, S.D. = 24.2). Sixty-one percent had moderate to high level of social support (mean = 70, S.D. = 13.3).The factors related to resilience were social support (Pearson’s r = 0.25, P < 0.01). The factor related to social support were age (Pearson’s r = -0.348, P < 0.01) and education (Pearson’s r = 0.31, P < 0.01) and the duration of treatment (Pearson’s r = 0.26, P < 0.01, and monthly income (Pearson’s r = 0.32, P < 0.01)

Conclusion : In this study of well-suppressed viral load and high CD4, HIV infected adults, majority of them had high levels of resilience and moderate to high level of social support. The higher of social support were associated to higher resilience score. Additionally, the social support was related to older age, higher educational level and the longer duration of HIV treatment.