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Self-Esteem and HIV Infection in Morocco: Associated Factors Among People Living with HIV—Results from a Community-Based Study

  • Adeline BernierEmail author
  • Amal Benmoussa
  • Mohamed Kamal Hilali
  • Emilie Henry
  • Joanne Otis
  • Mohamed Loukid
  • Marie Préau
Original Paper
  • 11 Downloads

Abstract

People living with HIV (PLHIV) face specific issues regarding mental quality of life (QoL), in particular self-esteem. The objective of this study was to measure self-esteem and to identify associated factors among PLHIV in Morocco. A 125-item questionnaire was administered to 300 PLHIV. The dependent variable was adapted from Rosenberg’s self-esteem scale (range 0–4). A weighted multiple linear regression was performed. The mean level of self-esteem was 2.4 ± 1.0. The factors independently associated with self-esteem were: feeling of loneliness (p = 0.001), perceived seriousness of infection (p = 0.006), thinking serostatus disclosure was a mistake (p = 0.007), thinking HIV infection will last for life (p = 0.008), sexual orientation (p = 0.050), satisfaction with sexual life (p = 0.019) and perceived treatment efficacy (p = 0.009). These results underline the need for evidence-based interventions (e.g. anti-discrimination measures, interventions to prevent social isolation of PLHIV, support in the serostatus disclosure process), in order to improve the social environment and eventually improve their self-esteem and QoL.

Keywords

Self-esteem People living with HIV Morocco Sexual orientation Serostatus disclosure Discrimination 

Notes

Acknowledgements

The authors would like to thank all those living with HIV who agreed to answer the study questionnaire, and the community-based organizations teams for their involvement in the organization of data collection. This study could not have been performed without the technical support provided by Coalition Internationale Sida and the financial support provided by the French Agency of AIDS Research (ANRS) and Sidaction. The authors would also like to thank the members of the PARTAGES group for their contribution in the implementation of this project.

References

  1. Anderson, R. M. (2013). Positive sexuality and its impact on overall well-being. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 56(2), 208–214.  https://doi.org/10.1007/s00103-012-1607-z.Google Scholar
  2. Baali, A., Lahmam, A., Amor, H., Aboussad, A., Boestch, G., & Chapuis-Lucciani, N. (2011). État de santé et environnement sociodémographique d’un groupe de personnes marocaines âgées. Actes du Colloque international de Meknès: Vieillissement de la population dans les pays du Sud. http://www.ceped.org/cdrom/meknes/spip6677.html?article27.
  3. Bing, E. G., Burnam, M. A., Longshore, D., Fleishman, J., Sherbourne, C., London, A., et al. (2001). Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry, 58(8), 721–728.  https://doi.org/10.1001/archpsyc.58.8.721.Google Scholar
  4. Chaudoir, S. R., Fisher, J. D., & Simoni, J. M. (2011). Understanding HIV disclosure: a review and application of the Disclosure Processes Model. Social Science & Medicine (1982), 72(10), 1618–1629.  https://doi.org/10.1016/j.socscimed.2011.03.028.Google Scholar
  5. ARCAD-SIDA, & Coalition, P. L. U. S. (2014). Gundo-So: la chambre des confidences / Une expérience communautaire sur la question du partage du statut sérologique chez les femmes vivant avec le VIH au Mali. Retrieved from http://www.coalitionplus.org/wordpress/wp-content/uploads/2014/12/Brochure_Gundo-So_finale.pdf.
  6. Coopersmith, S. (1967). The antecedents of self-esteem. San Francisco: W. H. Freeman & Co.Google Scholar
  7. Derlega, V. J., Winstead, B. A., Oldfield, I. I. I., E. C., & Barbee, A. P. (2003). Close relationships and social support in coping with HIV: a test of sensitive interaction systems theory. AIDS and Behavior, 7(2), 119–129.Google Scholar
  8. Eloirdi, A., Arfaoui, A., & Ahami, A. O. (2014). Evaluation de l’impact de l’estime de soi et de l’état dépressif sur la performance sportive chez les jeunes adolescents scolarisés. Antropo, 32, 25–34.Google Scholar
  9. Ferreira, C., Gay, M.-C., Regnier-Aeberhard, F., & Bricaire, F. (2010). Les représentations de la maladie et des effets secondaires du traitement antirétroviral comme déterminants de l’observance chez les patients VIH. Annales Médico-Psychologiques, Revue Psychiatrique, 168(1), 25–33.  https://doi.org/10.1016/j.amp.2007.09.005.Google Scholar
  10. Gadermann, A. M., Guhn, M., & Zumbo, B. D. (2012). Estimating ordinal reliability for likert-type and ordinal item response data: A conceptual, empirical, and practical guide. Practical Assessment, Research & Evaluation, 17(3), 1–13.Google Scholar
  11. Gonsiorek, J. C. (1988). Mental health issues of gay and lesbian adolescents. Journal of Adolescent Health Care: Official Publication of the Society for Adolescent Medicine, 9(2), 114–122.Google Scholar
  12. George L (2000). Well-being and sense of self: What we know and what we need to know. In K. W. Shaie & J. Hendricks (Eds.), Societal impact on the aging self. New York: Springer.Google Scholar
  13. Henry, E., Bernier, A., Lazar, F., Matamba, G., Loukid, M., Bonifaz, C., et al. (2015). ‘Was it a mistake to tell others that you are infected with HIV?’: Factors associated with regret following HIV disclosure among people living with HIV in five countries (Mali, Morocco, Democratic Republic of the Congo, Ecuador and Romania). Results from a community-based research. AIDS and Behavior, 19(2), 311–321.  https://doi.org/10.1007/s10461-014-0976-8.Google Scholar
  14. Herek, G. M., Saha, S., & Burack, J. (2013). Stigma and psychological distress in people with HIV/AIDS. Basic and Applied Social Psychology, 35(1), 41–54.  https://doi.org/10.1080/01973533.2012.746606.Google Scholar
  15. Higgins, J. A., Mullinax, M., Trussell, J., Davidson, J. K., & Moore, N. B. (2011). Sexual satisfaction and sexual health among university students in the United States. American Journal of Public Health, 101(9), 1643–1654.  https://doi.org/10.2105/AJPH.2011.300154.Google Scholar
  16. Human Rights Watch. (2015). Rapport mondial 2015: Maroc—Evènements de 2014. Retrieved from https://www.hrw.org/fr/world-report/2015/country-chapters/268159.
  17. Igartua, K. J., Gill, K., & Montoro, R. (2003). Internalized homophobia: a factor in depression, anxiety, and suicide in the gay and lesbian population. Canadian Journal of Community Mental Health = Revue Canadienne De Santé Mentale Communautaire, 22(2), 15–30.Google Scholar
  18. Johnston, L. G., Alami, K., El Rhilani, M. H., Karkouri, M, Mellouk, O., Abadie, A., et al (2013). HIV, syphilis and sexual risk behaviours among men who have sex with men in Agadir and Marrakesh, Morocco. Sexually Transmitted Infections, 89(Suppl 3), iii45–i48.  https://doi.org/10.1136/sextrans-2012-050918.Google Scholar
  19. Josephs, R. A., Markus, H. R., & Tafarodi, R. W. (1992). Gender and self-esteem. Journal of Personality and Social Psychology, 63(3), 391–402.Google Scholar
  20. Kouyoumjian, S. P., Mumtaz, G. R., Hilmi, N., Zidouh, A., El Rhilani, H., Alami, K., et al. (2013). The epidemiology of HIV infection in Morocco: systematic review and data synthesis. International Journal of STD & AIDS, 24(7), 507–516.  https://doi.org/10.1177/0956462413477971.Google Scholar
  21. Laryea, M., & Gien, L. (1993). The impact of HIV-positive diagnosis on the individual, Part 1: Stigma, rejection, and loneliness. Clinical Nursing Research, 2(3), 245–263. NaN-266.Google Scholar
  22. Lazăr, F., Verdeş, L., Henry, E., Fugon, L., Bernier, A., Otis, J., & Préau, M. (2014). Satisfaction with sexual life in people living with HIV in Romania, together with associated individual and social factors. AIDS Care, 26(Suppl 1), S65–S69.  https://doi.org/10.1080/09540121.2014.906550.Google Scholar
  23. Letta, S., Demissie, A., Oljira, L., & Dessie, Y. (2015). Factors associated with adherence to Antiretroviral Therapy (ART) among adult people living with HIV and attending their clinical care, Eastern Ethiopia. BMC International Health and Human Rights, 15(1), 33.  https://doi.org/10.1186/s12914-015-0071-x.Google Scholar
  24. Manhas, C. (2014). Self-esteem and quality of life of people living with HIV/AIDS. Journal of Health Psychology, 19(11), 1471–1479.  https://doi.org/10.1177/1359105313493812.Google Scholar
  25. Martinot, D. (2001). Connaissance de soi et estime de soi: ingrédients pour la réussite scolaire. Revue Des Sciences de L’éducation, 27(3), 483.  https://doi.org/10.7202/009961ar.Google Scholar
  26. McMullin, J. A., & Cairney, J. (2004). Self-esteem and the intersection of age, class, and gender. Journal of Aging Studies, 18(1), 75–90.  https://doi.org/10.1016/j.jaging.2003.09.006.Google Scholar
  27. Ministère de la Santé (Royaume du Maroc). (2015). Mise en oeuvre de la déclaration politique sur le VIH/SIDA—Rapport national 2015. Retrieved from http://www.unaids.org/sites/default/files/country/documents/MAR_narrative_report_2015.pdf.
  28. Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology & Health, 17(1), 1–16.  https://doi.org/10.1080/08870440290001494.Google Scholar
  29. Mumtaz, G. R., Weiss, H. A., Thomas, S. L., Riome, S., Setayesh, H., Riedner, G., et al. (2014). HIV among people who inject drugs in the Middle East and North Africa: Systematic review and data synthesis. PLoS Medicine, 11(6), e1001663.  https://doi.org/10.1371/journal.pmed.1001663.Google Scholar
  30. Nunnally, J. C. (1978). Psychometric theory. New York: McGraw-Hill.Google Scholar
  31. Orth, U., Robins, R. W., & Meier, L. L. (2009). Disentangling the effects of low self-esteem and stressful events on depression: Findings from three longitudinal studies. Journal of Personality and Social Psychology, 97(2), 307–321.  https://doi.org/10.1037/a0015645.Google Scholar
  32. Orth, U., Trzesniewski, K. H., & Robins, R. W. (2010). Self-esteem development from young adulthood to old age: A cohort-sequential longitudinal study. Journal of Personality and Social Psychology, 98(4), 645–658.  https://doi.org/10.1037/a0018769.Google Scholar
  33. Pence, B. W. (2009). The impact of mental health and traumatic life experiences on antiretroviral treatment outcomes for people living with HIV/AIDS. Journal of Antimicrobial Chemotherapy, 63(4), 636–640.  https://doi.org/10.1093/jac/dkp006.Google Scholar
  34. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton: Princeton University Press.Google Scholar
  35. Ross, M. W., Rosser, B. R. S., Bauer, G. R., Bockting, W. O., Robinson, B., ‘Bean’, E., et al. (2001). Drug use, unsafe sexual behavior, and internalized homonegativity in men who have sex with men. AIDS and Behavior, 5(1), 97–103.  https://doi.org/10.1023/A:1009567707294.Google Scholar
  36. Shaw, B. A., Liang, J., & Krause, N. (2010). Age and race differences in the trajectories of self-esteem. Psychology and Aging, 25(1), 84–94.  https://doi.org/10.1037/a0018242.Google Scholar
  37. Simoni, J. M., Montoya, H. D., Huang, B., & Goodry, E. (2005). Social support and depressive symptomatology among HIV-positive women: The mediating role of self-esteem and mastery. Women & Health, 42(4), 1–15.Google Scholar
  38. Skevington, S. M., Norweg, S., Standage, M., & WHOQOL HIV Group (2010). Predicting quality of life for people living with HIV: International evidence from seven cultures. AIDS Care, 22(5), 614–622.  https://doi.org/10.1080/09540120903311466.Google Scholar
  39. Sowislo, J. F., & Orth, U. (2013). Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychological Bulletin, 139(1), 213–240.  https://doi.org/10.1037/a0028931.Google Scholar
  40. Spire, B., Duran, S., Souville, M., Leport, C., Raffi, F., Moatti, J.-P., & APROCO cohort study group (2002). Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to a dynamic approach. Social Science & Medicine (1982), 54(10), 1481–1496.Google Scholar
  41. Stutterheim, S. E., Bos, A. E. R., Pryor, J. B., Brands, R., Liebregts, M., & Schaalma, H. P. (2011). Psychological and social correlates of HIV status disclosure: the significance of stigma visibility. AIDS Education and Prevention: Official Publication of the International Society for AIDS Education, 23(4), 382–392.  https://doi.org/10.1521/aeap.2011.23.4.382.Google Scholar
  42. The World Health Organization Quality of Life Assessment (WHOQOL). (1998). development and general psychometric properties. Social Science & Medicine (1982), 46(12), 1569–1585.Google Scholar
  43. Twenge, J. M., & Campbell, W. K. (2002). Self-esteem and socioeconomic status: A meta-analytic review. Personality and Social Psychology Review, 6(1), 59–71.  https://doi.org/10.1207/S15327957PSPR0601_3.Google Scholar
  44. UNAIDS. (2012). HIV and AIDS estimates—Morocco. Retrieved 14 January, 2016, from http://www.unaids.org/en/regionscountries/countries/morocco.
  45. van Dyk, A. C. (2008). HIV AIDS care & counselling (4th ed.). Cape Town: Pearson South Africa.Google Scholar
  46. Yehia, B. R., Stewart, L., Momplaisir, F., Mody, A., Holtzman, C. W., Jacobs, L. M., et al. (2015). Barriers and facilitators to patient retention in HIV care. BMC Infectious Diseases, 15, 246.  https://doi.org/10.1186/s12879-015-0990-0.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Coalition Internationale SidaPantinFrance
  2. 2.Association de Lutte Contre le SidaCasablancaMorocco
  3. 3.Faculty of Science SemlaliaUniversité Cadi AyyadMarrakechMorocco
  4. 4.Université du Québec à MontréalMontrealCanada
  5. 5.Groupe de Recherche en Psychologie SocialeUniversité Lumière Lyon 2LyonFrance

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