Abstract

This study explored the HIV-related stressors that people living with HIV (PLWH) commonly experience and express as stressful at the time of diagnosis and 1 year later. The factors associated with stress levels and whether social support would moderate the negative effects of stress on psychological health (depressive and anxiety symptoms) were also investigated. Newly diagnosed PLWH were consecutively recruited in this study. Participants rated their stress with the HIV/AIDS Stress Scale at baseline and 1 year later. Social support, depression, and anxiety were also self-reported at both time points. There were significant decreases in stress levels 1 year after diagnosis. Stressors regarding confidentiality, disclosure, emotional distress, fear of infecting others, and excessive attention to physical functions were the most problematic at baseline and 1-year follow-up. A younger age, married status, not living alone, less income, presence of HIV symptoms, and lack of social support were associated with higher levels of stress. No stress-buffering effect of social support on depressive and anxiety symptoms was found in this study. Interventions to reduce stress among PLWH should take into consideration the following priority stressors: confidentiality, discrimination/stigma, serostatus disclosure, distressing emotions, fear of infecting others, and excessive attention to physical functions. More attention should be paid to PLWH with younger age, not living alone, less income, presence of HIV symptoms, and lack of social support.

Highlights

  • Active antiretroviral therapy (ART) has contributed to dramatic declines in the rate of morbidity and mortality in people living with HIV (PLWH) [1]

  • A self-administered questionnaire including HIV-related stress, social support, depression, anxiety, and socio-demographic and clinical information was completed by eligible participants at baseline and 1-year follow-up

  • Participants lost to follow-up were more likely to be employed than those who completed the follow-up survey (p = 0.015)

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Summary

Introduction

Active antiretroviral therapy (ART) has contributed to dramatic declines in the rate of morbidity and mortality in people living with HIV (PLWH) [1]. HIV infection, rather than a terminal disease, is treated more like a chronic illness [2]. Threats regarding physical survival have to some extent been replaced by the mental health burden related to HIV [3,4]. Being diagnosed with HIV is a traumatic experience for the great majority of individuals, posing considerable stress related to HIV such as HIV-related stigma, disclosure concerns, antiretroviral treatment, and physical changes [5]. PLWH are, more likely to suffer from greater levels of stress [6].

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