Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 2/2019

Open Access 01-09-2019 | Human Immunodeficiency Virus | Original Paper

The People Living with HIV (PLHIV) Resilience Scale: Development and Validation in Three Countries in the Context of the PLHIV Stigma Index

Authors: A. Gottert, B. Friedland, S. Geibel, L. Nyblade, S. D. Baral, S. Kentutsi, C. Mallouris, L. Sprague, J. Hows, F. Anam, U. Amanyeiwe, J. Pulerwitz

Published in: AIDS and Behavior | Special Issue 2/2019

Login to get access

Abstract

Supporting resilience among people living with HIV (PLHIV) is crucial to their sustained uptake of HIV services as well as psychological and social wellbeing. However, no measures exist to assess resilience specifically in relation to living with HIV. We developed the PLHIV Resilience Scale and evaluated its performance in surveys with 1207 PLHIV in Cameroon, Senegal and Uganda as part of the PLHIV Stigma Index—the most widely used tool to track stigma and discrimination among PLHIV worldwide. Factor analyses demonstrated satisfactory psychometric properties and reliability (alphas = 0.81–0.92). Levels of resilience (e.g., whether one’s self-respect has been positively, negatively, or not affected by one’s HIV status) varied substantially within and across countries. Higher resilience was associated with less depression in each country (all p < 0.001), and, in Cameroon and Uganda, better self-rated health and less experience of stigma/discrimination (all p < 0.001). The final 10-item PLHIV Resilience Scale can help inform interventions and policies.
Literature
1.
Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. The Lancet. 2013;382(9903):1525–33.CrossRef
2.
World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: World Health Organization; 2015.
3.
The Lancet HIV Editors. U = U taking off in 2017. Lancet HIV. 2017;4(11):PE475.CrossRef
4.
5.
Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.PubMedCrossRef
6.
7.
Ungar M. The social ecology of resilience: A handbook of theory and practice. Berlin: Springer Science & Business Media; 2011.
8.
Dulin AJ, Dale SK, Earnshaw VA, Fava JL, Mugavero MJ, Napravnik S, et al. Resilience and HIV: a review of the definition and study of resilience. AIDS Care. 2018;30:1–12.CrossRef
9.
Brown G, Mikołajczak G, Lyons A, Power J, Drummond F, Cogle A, et al. Development and validation of PozQoL: a scale to assess quality of life of PLHIV. BMC Public Health. 2018;18(1):527.PubMedPubMedCentralCrossRef
10.
Farber EW, Schwartz JA, Schaper PE, Moonen DJ, McDaniel JS. Resilience factors associated with adaptation to HIV disease. Psychosomatics. 2000;41(2):140–6.PubMedCrossRef
11.
Wadley AL, Mitchell D, Kamerman PR. Resilience does not explain the dissociation between chronic pain and physical activity in South Africans living with HIV. PeerJ. 2016;4:e2464.PubMedPubMedCentralCrossRef
12.
Dale SK, Weber KM, Cohen MH, Kelso GA, Cruise RC, Brody LR. Resilience moderates the association between childhood sexual abuse and depressive symptoms among women with and at-risk for HIV. AIDS Behav. 2015;19(8):1379–87.PubMedPubMedCentralCrossRef
13.
Li H, Tucker J, Holroyd E, Zhang J, Jiang B. Suicidal ideation, resilience, and healthcare implications for newly diagnosed HIV-positive men who have sex with men in China: a qualitative study. Archiv Sex Behav. 2017;46(4):1025–34.CrossRef
14.
Logie C, James L, Tharao W, Loutfy M. Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario Canada. AIDS Patient Care STDs. 2013;27(2):114–22.PubMedCrossRef
15.
Scorza P, Duarte CS, Stevenson A, Mushashi C, Kanyanganzi F, Munyana M, et al. Individual-level factors associated with mental health in Rwandan youth affected by HIV/AIDS. Soc Psychiatry Psychiatr Epidemiol. 2017;52(7):867–75.PubMedPubMedCentralCrossRef
16.
Spies G, Seedat S. Depression and resilience in women with HIV and early life stress: does trauma play a mediating role? A cross-sectional study. BMJ Open. 2014;4(2):e004200.PubMedPubMedCentralCrossRef
17.
Thurston IB, Howell KH, Kamody RC, Maclin-Akinyemi C, Mandell J. Resilience as a moderator between syndemics and depression in mothers living with HIV. AIDS Care. 2018;30:1–8.CrossRef
18.
Colasanti J, Stahl N, Farber EW, del Rio C, Armstrong WS. An exploratory study to assess individual and structural level barriers associated with poor retention and re-engagement in care among persons living with HIV/AIDS. JAIDS J Acquir Immune Defic Syndr. 2017;74:S113–20.PubMedCrossRef
19.
Geter A, Sutton MY, McCree Hubbard D. Social and structural determinants of HIV treatment and care among black women living with HIV infection: a systematic review: 2005–2016. AIDS Care. 2018;30(4):409–16.PubMedPubMedCentralCrossRef
20.
Kerkerian G, Kestler M, Carter A, Wang L, Kronfli N, Sereda P, et al. Attrition across the HIV cascade of care among a diverse cohort of women living with HIV in Canada. JAIDS J Acquir Immune Defic Syndr. 2018;79(2):226–36.PubMedCrossRef
21.
Michlig GJ, Westergaard RP, Lam Y, Ahmadi A, Kirk GD, Genz A, et al. Avoidance, meaning and grief: psychosocial factors influencing engagement in HIV care. AIDS Care. 2018;30(4):511–7.PubMedCrossRef
22.
Remien RH, Bauman LJ, Mantell J, Tsoi B, Lopez-Rios J, Chhabra R, et al. Barriers and facilitators to engagement of vulnerable populations in HIV primary care in New York City. J Acquir Immune Defic Syndr (1999). 2015;69(0 1):S16.CrossRef
23.
Dale S, Cohen M, Weber K, Cruise R, Kelso G, Brody L. Abuse and resilience in relation to HAART medication adherence and HIV viral load among women with HIV in the United States. AIDS Patient Care STDs. 2014;28(3):136–43.PubMedPubMedCentralCrossRef
24.
Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depress Anxiety. 2003;18(2):76–82.PubMedCrossRef
25.
Dale SK, Cohen MH, Kelso GA, Cruise RC, Weber KM, Watson C, et al. Resilience among women with HIV: impact of silencing the self and socioeconomic factors. Sex Roles. 2014;70(5–6):221–31.PubMedPubMedCentralCrossRef
26.
de Araújo LF, Teva I, Quero JH, Reyes AO, de la Paz Bermúdez M. Analysis of resilience and sexual behavior in persons with HIV infection. Psicologia. 2017;30(1):21.
27.
Zhang L, Li X, Qiao S, Zhou Y, Shen Z, Tang Z, et al. The mediating role of individual resilience resources in stigma–health relationship among people living with HIV in Guangxi China. AIDS Care. 2015;27(10):1317–25.PubMedPubMedCentralCrossRef
28.
Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194–200.PubMedCrossRef
29.
Earnshaw VA, Lang SM, Lippitt M, Jin H, Chaudoir SR. HIV stigma and physical health symptoms: do social support, adaptive coping, and/or identity centrality act as resilience resources? AIDS Behav. 2015;19(1):41–9.PubMedPubMedCentralCrossRef
30.
Sinclair VG, Wallston KA. The development and psychometric evaluation of the brief resilient coping scale. Assessment. 2004;11(1):94–101.PubMedCrossRef
31.
Cohen MZ, Kupzyk KA, Holley LM, Katzman RM. Measuring resilience in two generations: psychometric properties of available instruments. J Nurs Meas. 2017;25(2):332–52.PubMedCrossRef
32.
De Santis JP, Florom-Smith A, Vermeesch A, Barroso S, DeLeon DA. Motivation, management, and mastery: a theory of resilience in the context of HIV infection. J Am Psychiatr Nurses Assoc. 2013;19(1):36–46.PubMedPubMedCentralCrossRef
33.
Stackpool-Moore L, Yuvaraj A. Measuring for change: a new research initiative by and for people living with HIV. HIV/AIDS Policy Law Rev. 2008;13(2–3):86–7.
34.
The People Living with HIV Stigma Index: an index to measure the stigma and discrimination experienced by people living with HIV. 2017.
35.
Population Council. Updating the People Living with HIV Stigma Index. 2017.
36.
Friedland BA, Sprague L, Nyblade L, Baral SD, Pulerwitz J, Gottert A, et al. Measuring intersecting stigma among key populations living with HIV: implementing the people living with HIV stigma index 2.0. J Int AIDS Soc. 2018;21((Suppl Suppl 5)):e25131.PubMedPubMedCentralCrossRef
37.
38.
39.
StataCorp. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC; 2017.
40.
Bollen KA. Structural equations with latent variables. New Jersey: Wiley; 1989.CrossRef
41.
Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1–55.CrossRef
42.
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297–334.CrossRef
43.
Zumbo BD, Gadermann AM, Zeisser C. Ordinal versions of coefficients alpha and theta for Likert rating scales. J Mod Appl Stat Methods. 2007;6(1):4.CrossRef
44.
Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics. 2009;50(6):613–21.PubMed
45.
Willis GB. Analysis of the cognitive interview in questionnaire design. Oxford: Oxford University Press; 2015.
46.
UNAIDS. Undetectable = Untransmittable: Public health and HIV viral load suppression. 2018.
47.
48.
Herrick AL, Lim SH, Wei C, Smith H, Guadamuz T, Friedman MS, et al. Resilience as an untapped resource in behavioral intervention design for gay men. AIDS Behav. 2011;15(1):25–9.CrossRef
49.
Rao D, Andrasik MP, Lipira L. HIV stigma among black women in the United States: intersectionality, support, resilience. Am Public Health Assoc. 2018;108(4):446–8.CrossRef
50.
51.
Pulerwitz J, Michaelis A, Weiss E, Brown L, Mahendra V. Reducing HIV-related stigma: lessons learned from Horizons research and programs. Public Health Rep. 2010;125(2):272–81.PubMedPubMedCentralCrossRef
52.
Stangl AL, Lloyd JK, Brady LM, Holland CE, Baral S. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come? J Int AIDS Soc. 2013;16:18734.PubMedPubMedCentralCrossRef
53.
Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.PubMedCrossRef
54.
Scott-Sheldon LA, Kalichman SC, Carey MP, Fielder RL. Stress management interventions for HIV + adults: a meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychol. 2008;27(2):129.PubMedPubMedCentralCrossRef
Metadata
Title
The People Living with HIV (PLHIV) Resilience Scale: Development and Validation in Three Countries in the Context of the PLHIV Stigma Index
Authors
A. Gottert
B. Friedland
S. Geibel
L. Nyblade
S. D. Baral
S. Kentutsi
C. Mallouris
L. Sprague
J. Hows
F. Anam
U. Amanyeiwe
J. Pulerwitz
Publication date
01-09-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue Special Issue 2/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02594-6

Other articles of this Special Issue 2/2019

AIDS and Behavior 2/2019 Go to the issue

Original Paper

Gender Norms and HIV Testing/Treatment Uptake: Evidence from a Large Population-Based Sample in South Africa

Original Paper

Leveraging Geospatial Approaches to Characterize the HIV Prevention and Treatment Needs of Out-of-School Adolescent Girls and Young Women in Ethiopia

Original Paper

The Role of Depression Screening and Treatment in Achieving the UNAIDS 90–90–90 Goals in Sub-Saharan Africa

Original Paper

Engaging Stakeholders, from Inception and Throughout the Study, is Good Research Practice to Promote use of Findings

Original Paper

Research Capacity Strengthening in Sub-Saharan Africa: Recognizing the Importance of Local Partnerships in Designing and Disseminating HIV Implementation Science to Reach the 90–90–90 Goals

Correction

Correction to: Re-thinking Linkage to Care in the Era of Universal Test and Treat: Insights from Implementation and Behavioral Science for Achieving the Second 90
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits