An estimated 30 to 36 million people worldwide are living with the Human
Immunodeficiency Virus (HIV). In 2009 about 5.7 million of the 30 to 36 million people who
are infected with HIV were living in South Africa, making South Africa the country with the
largest number of people infected with HIV in the world (UNGASS, 2010). Van Dyk (2008)
states that HIV infection and Acquired Immunodeficiency Syndrome (AIDS) are
accompanied by symptoms of psycho–social distress, but relatively little is known of the
direct effect of HIV and AIDS on psychological well–being. The psychological distress is
mainly due to the difficulties HIV brings to daily life and the harsh reality of the prognosis of
the illness (Van Dyk, 2008). It is not clear whether people infected with HIV who are
unaware of their HIV status show more psychological symptoms than people in a group not
infected with HIV. The research question for the current study was therefore whether people
with and without HIV infection differ in their psycho–social symptoms and strengths before
they know their HIV status. Accordingly, the aim of this study was to explore the psychosocial
health profiles of people with and without HIV and AIDS before they knew their
infection status.
A cross–sectional survey design was used for gathering psychological data. This was part of a
multi–disciplinary study where the participants’ HIV status was determined after obtaining
their informed consent and giving pre– and post–test counselling. This study falls in the
overlap of the South African leg of the Prospective Urban and Rural Epidemiology study (PURE–SA) that investigates the health transition and chronic diseases of lifestyle in urban
and rural areas (Teo, Chow, Vaz, Rangarajan, & Ysusf, 2009), and the FORT2 and 3 projects
(FORT2 = Understanding and promoting psychosocial health, resilience and strengths in an
African context; Fort 3 = The prevalence of levels of psychosocial health: Dynamics and
relationships with biomarkers of (ill) health in the South African contexts) (Wissing, 2005,
2008) on psychological well–being and its biological correlates. All the baseline data were
collected during 2005. Of the 1 025 participants who completed all of the psychological
health questionnaires, 153 (14.9%) were infected with HIV and 863 were not infected with
HIV (since the HIV status of nine of the participants was not known, they were not included
in the study). In the urban communities 435 participants completed the psychological health
questionnaires, of whom 68 (15.6%) were infected with HIV and 367 were not infected with
HIV. In the rural communities, 581 participants completed the psychological health
questionnaires, of whom 85 (14.6%) were infected with HIV and 496 were not infected with
HIV. The validated Setswana versions of the following seven psychological health
questionnaires were used: Affectometer 2 (AFM), Satisfaction With Life Scale (SWLS),
Community Collective Efficacy Scale (CCES), Mental Health Continuum Short Form
(MHC–SF), New General Self–efficacy Scale (NGSE), Sense of Coherence Scale (SOC) and
the General Health Questionnaire (GHQ). Descriptive statistics were determined for all
measures for all the participants with, and without HIV. Significant differences in psychosocial
profiles among individuals with and without HIV and AIDS and also between those in
the rural and urban areas were determined by means of t–tests and by a multivariate analysis
of variance (MANOVA). Practical significance was determined by the size of the effects.
The results for the entire group showed statistically significant differences between the two
groups of participants who were infected with HIV and those not infected with HIV regarding their sense of coherence and their perspective on the community’s capacity to succeed in joint
activities, but these differences were of only small practical significance. The HIV–infected
participants in the urban areas displayed statistically and practically a lower sense of
coherence and viewed themselves as less capable of meeting task demands in community
contexts, than did the participants not infected with HIV. Though the participants not infected
with HIV in the rural group had, statistically and practically, a significantly greater capacity
to succeed in joint community activities than the participants infected with HIV, an
interesting finding was that the participants infected with HIV experienced more positive
affect than the participants not infected with HIV. The research showed that people with and
without HIV infection differ in some respects in their psycho–social symptoms and strengths
even before they are conscious of their HIV status.
It is striking that the differences found on the psychological measures for the participants
reflected a personal sense of social coherence and perspective on their community’s capacity
to succeed in joint activities, which was lower in the case of participants infected with HIV,
and might therefore have led to high–risk social behaviours and consequent infections. It
might be that the participants with a relatively lower sense of social coherence, integration,
and co–operation towards collectively achieving meaningful goals were more inclined to
manifest behaviours that would lead to detrimental consequences (in this case HIV infection)
for themselves and others. The higher level of positive affect in the rural group of the
participants infected with HIV is still unexplained and requires further research. / Thesis (M.Sc. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nwu/oai:dspace.nwu.ac.za:10394/4696 |
| Date | January 2010 |
| Creators | Maré, Lanél |
| Publisher | North-West University |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
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