A qualitative study of older people living with HIV Hong Kong: Resilience through downward comparison amidst limited social support

Abstract

Research on older people living with HIV (OPHIV) highlights social support as an important dimension of their resilience and coping resources. This study asks: in face of high perceived risk of HIV status disclosure, how do OPHIV cope when they have little social support from family and friends? Methods: This study broadens the study of OPHIV beyond North America and Europe and presents a case study of Hong Kong. In collaboration with the longest-running non-governmental organization working on HIV/AIDS issues in Hong Kong, 21 interviews with OPHIV were conducted. Results: It was found that a vast majority of them did not disclose their HIV status and many lacked social support from family and friends. The OPHIV in Hong Kong turned instead to coping through downward comparison, drawing on a comparison between their current lives with: (1) how they themselves experienced HIV in their earlier life; (2) how HIV was socially treated in the past; (3) how HIV was medically treated in the past; (4) growing up under harsh economic circumstances when industrialization and rapid economic development took place in Hong Kong; (5) Eastern religions, spiritual support and the associated philosophy of ‘letting go’ and acceptance. Conclusions: This study has found that in face of high perceived risk of HIV status disclosure, where OPHIV have little social support from family and friends, they used the psychological mechanism of downward comparison to maintain positivity. The findings also contextualize the lives of OPHIV against the historical development of Hong Kong.