Direct and Indirect Associations Between Interpersonal Resources and Posttraumatic Growth Through Resilience Among Women Living with HIV in China
- 45 Downloads
This study aims to test the associations between interpersonal resources and posttraumatic growth (PTG) and their indirect associations through resilience among women living with HIV (WLWH). A cross-sectional study interviewed 546 WLWH from eight clinics of Yunnan and Guangxi provinces in China. PTG, resilience and doctors’ empathy were assessed by the validated scales. Family support, friend support, and partner intimacy were assessed by the self-constructed scales. Significant background factors of PTG included duration of residence in the area, monthly family income, number of years since HIV diagnosis, self-reported presence of AIDS-related symptoms, and current pregnancy. Family social support, partner intimacy, doctors’ empathy, and resilience were positively associated with PTG; friend support was negatively associated with PTG (p < .05). Furthermore, resilience partially mediated the relationships between family support/partner intimacy and PTG, explaining 13.6–14.2% of the variance. Structural equation modeling showed that family support was significantly and indirectly associated with PTG through resilience when controlling for other interpersonal resource indicators. Implications and potential interventions to promote PTG are discussed.
KeywordsFamily/friend support Intimacy with partner Doctors’ empathy Resilience Posttraumatic growth
XY and JTFL conceptualized the aims and hypotheses for the study and took primary responsibility for drafting the manuscript. QW as the grant holder contributed to the original study design and questionnaire, research questions, fieldwork coordination, and comments to the manuscript. XW assisted with data analyses and drafting results. PM designed the original study and questionnaire. ZW took primary responsibility for data cleaning. LW provided advice to the project and organizational support.
This work was supported by the Women Health Branch of the Chinese Preventive Medicine Association.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
The manuscript does not contain clinical studies or patient data. The study procedures were carried out in accordance with the Declaration of Helsinki. Ethics approval was obtained from the Ethics Committee of the Chinese University of Hong Kong.
- 1.World Health Organization. Global AIDS update. 2016. Retrieved from https://www.who.int/hiv/pub/arv/global-AIDS-update-2016_en.pdf?ua=1.
- 4.King MB. AIDS, HIV and mental health. Cambridge: Cambridge University Press; 1993.Google Scholar
- 9.Cook JA, Burke-Miller JK, Steigman PJ, Schwartz RM, Hessol NA, Milam J. Prevalence, comorbidity, and correlates of psychiatric and substance use disorders and associations with HIV risk behaviors in a multisite cohort of women living with HIV. AIDS Behav. 2018;22:3141–54.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Yu NX, Chen LH, Ye Z, Li XM, Lin DH. Impacts of making sense of adversity on depression, posttraumatic stress disorder, and posttraumatic growth among a sample of mainly newly diagnosed HIV-positive Chinese young homosexual men: the mediating role of resilience. Aids Care. 2017;29(1):79–85.CrossRefPubMedGoogle Scholar
- 26.Dong XL, Li GP, Liu CL, Kong LH, Fang YY, Kang XF, et al. The mediating role of resilience in the relationship between social support and posttraumatic growth among colorectal cancer survivors with permanent intestinal ostomies: a structural equation model analysis. Eur J Oncol Nurs. 2017;29:47–52.CrossRefPubMedGoogle Scholar
- 27.Calhoun LG, Cann A, Tedeschi RG. The posttraumatic growth model: sociocultural considerations. In: Weiss T, Berger R, editors. Posttraumatic growth and culturally competent practice. Hoboken: Wiley; 2010.Google Scholar
- 29.Werner EE, Bierman JM, French FE. The children of Kauai: a longitudinal study from the prenatal period to age ten. Honolulu: University of Hawaii Press; 1971.Google Scholar
- 35.Lepore SJ, Revenson TA. Resilience and posttraumatic growth: recovery, resistance, and reconfiguration. Mahwah: Lawrence Erlbaum Associates Publishers; 2006.Google Scholar
- 36.Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007;4(5):35–40.Google Scholar
- 64.Tedeschi RG, Tedeschi RG, Park CL, Calhoun LG. Posttraumatic growth: conceptual issues. In: Tedeschi RG, Tedeschi RG, Park CL, Calhoun LG, editors. Posttraumatic Growth: Positive Changes in the Aftermath of Crises. Mahwah: Erlbaum; 1998.Google Scholar
- 65.Li J, Mao Y, Tang H, Han J, Xu J, Wu Z. Analysis of factors associated with antiretroviral therapy initiation and its timeliness among HIV sero-discordant couples in high HIV prevalence regions, China. Chin J Prev Med. 2015;49(7):625–31.Google Scholar
- 69.Gu J, Lau JTF, Wang Z, Wu AMS, Tan X. Perceived empathy of service providers mediates the association between perceived discrimination and behavioral intention to take up HIV antibody testing again among men who have sex with men. PLoS ONE. 2015;10(2):e0117376.CrossRefPubMedPubMedCentralGoogle Scholar
- 73.Hayes AF. PROCESS: a versatile computational tool for observed variable mediation, moderation, and conditional process modeling. http://www.afhayes.com/public/process2012.pdf. 2012.
- 88.Maman S, Mbwambo JK, Hogan NM, Weiss E, Kilonzo GP, Sweat MD. High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. AIDS Behav. 2003;7(4):373–82.CrossRefPubMedGoogle Scholar
- 96.Prati G, Pietrantoni L. Optimism, social support and coping strategies as factors contributing to posttraumatic growth: a meta-analysis. Psychol Health. 2009;24:44.Google Scholar