A Cross-Sectional Relationship Between Social Capital, Self-Compassion, and Perceived HIV Symptoms

Abstract

Context Individual resources of social capital and self-compassion are associated with health behaviors and perceived symptoms, suggesting that both are positive resources that can be modified to improve a person’s symptom experience. Objectives To examine the relationship between self-compassion and social capital and its impact on current HIV symptom experience in adult people living with HIV (PLWH). We further explored the impact of age on this relationship. Methods We conducted a cross-sectional analysis of 2182 PLWH at 20 sites in five countries. Social capital, self-compassion, and HIV symptom experience were evaluated using valid and reliable scales. To account for inflated significance associated with a large sample size, we took a random sample of 28% of subjects (n=615) and conducted correlation analyses and zero inflated Poisson regression, controlling for known medical and demographic variables impacting HIV symptom experience. Results Controlling for age, sex at birth, year of HIV diagnosis, comorbid health conditions, employment and income, our model significantly predicted HIV symptom experience (overall model z =5.77, P<0.001). Employment status and social capital were consistent, negative and significant predictors of HIV symptom experience. Self-compassion did not significantly predict HIV symptom experience. If reporting symptoms, an increase in age was significantly associated with an increase in symptoms. Conclusion Employment and social capital modestly predicted current HIV symptom experience. Social capital can be incorporated into symptom management interventions, possibly as a way to reframe a person’s symptom appraisal. This may be increasingly important as PLWH age. The relationship between employment status and HIV symptom experience was significant and should be explored further.

Social Capital and Quality of Life Among People Living With HIV/AIDS in Southeast China

“…Interventions aimed at improving medication adherence among PLWH in China should include a focus on increasing social capital as research in the United States has shown that social capital is associated with ART adherence. 27 Consistent with other studies, 7,19 we found that PLWH who were unemployed and had unstable income had low PHS and MHS scores. PLWH with lower employment and income may lack material resources, have fewer opportunities to connect with others, and have less access to health and social services, 28 ultimately impacting their QoL.…”

“…This supports results from a large study in 6 countries, including China, that found bivariate associations between social capital and self-reported physical and psychological health 17 and research in the United States demonstrating an association between social capital and overall life satisfaction. 18 Social capital has also been found to decrease HIV symptom intensity, 19 which likely results in greater QoL among PLWH. Social capital is an important component of the social environment and may have an important influence on health.…”

Racial and socioeconomic disparities in the symptom reporting of persons living with HIV

“…(31, 36, 37, 44, 51, 52) Many of the prior studies on the symptom experience and incidence in PLWH were conducted at a single site(32–34) or were conducted before the age of cART. (23, 24, 53, 54) We did not use two frequently used HIV symptom indexes since these instruments were developed before the advent of advanced cART.…”

“…(22) Consequently, Much of the research on the symptom experience among PLWH is dated,(23–31) restricted to single site studies,(32–35) and based on old symptom indexes. (28, 29, 33, 34, 36–40) Therefore, it is clear that the symptom experience of PLWH today needs to be understood in the context of cART, including once a day regimens, long-term adherence to ART medications, and age-related comorbidities as opposed to illness progression and toxicity associated with early ART regimens. (21)…”

“…Past research has shown that those from low socioeconomic groups are more likely to report higher symptom burden. (41, 42) In contrast, racial and ethnic differences in symptom burden are inconclusive with some studies finding symptom burden to differ between racial/ethnic groups,(33, 36, 40, 43) and others finding no significant differences between groups. (28, 37, 44) Overall, the literature on HIV self-reported data is very sparse and has mainly focused on self-reported CD4 counts and health service utilization among marginalized populations living with HIV.…”