Associations between social support, resilience, HIV stigma, and depression among people living with HIV in Malang, Indonesia: A cross-sectional study

Abstract

Objective — This study aimed at analyzing the associations between social support, resilience, HIV stigma and depression among people living with HIV (PLHIV) in Malang, Indonesia. Material and Methods — We carried out a cross-sectional study using convenience sampling at four community health centers in Malang, Indonesia, from June to September 2018. All PLHIV 18 years of age and older coming to a healthcare center for medical services were offered a possibility to participate in this study. Consequently, 634 PLHIV enrolled in antiretroviral therapy (ART) programs were recruited. Measurement tests included sociodemographic questionnaire, Multidimensional Scale of Perceived Social Support (MSPSS), HIV Stigma Scale, Connor–Davidson Resilience Scale (10-item version), and Center for Epidemiological Studies Depression Scale Revised (CESD-R). While maintaining the confidentiality in the course of data collection, clinical staff assisted with recruiting and face-to-face interviews via standardized questionnaires. Multivariate logistic regression models were employed to assess the relationships between predictors and depression. Results — A multivariate logistic regression analysis revealed that higher levels of social support and resilience, along with a lack of stigma, were associated with lower levels of depressive symptoms (Nagelkerke's R2=0.2). Conclusion — Calls to action to encourage and raise public awareness through health policies in Indonesia that focus on improving social support and resilience, as well as reducing social stigma, may have a positive impact on supporting the psychological health of PLHIV.