Compassionate Love as a Predictor of Reduced HIV Disease Progression and Transmission Risk

Abstract

Objectives. This study examined if compassionate love (CL) predicts HIV disease progression and transmission risk. Scientific study of CL emerged with Underwood's working model of other-centered CL, defining five criteria: free choice, cognitive understanding, valuing/empowering, openness/receptivity for spirituality, and response of the heart. Method. This 10-year cohort study collected 6-monthly interviews/essays on coping with HIV and trauma of 177 people with HIV in South Florida. Secondary qualitative content analysis on other-centered CL inductively added the component of CL towards self. Deductively, we coded the presence of the five criteria of CL and rated the benefit of CL for the recipient on a 6-point Likert scale. Growth-curve modeling (reduced to 4 years due to cohort effects) investigated if CL predicts CD4 slope (HIV disease progression) and cumulative viral load detection (transmission risk). Results. Valuing/empowering and cognitive understanding were the essential criteria for CL to confer long-term benefits. CL had a higher benefit for recipients if given out of free choice. High scores of CL towards self were reciprocal with receiving (93%) and giving (77%) other-centered CL. Conversely, those rated low on CL towards self were least likely to score high on receiving (38%) and giving (49%) other-centered CL. Growth-curve modeling showed that CL towards self predicted 4-year cumulative undetectable viral load (independent from sociocultural differences, substance use disorder, baseline CD4 and viral load). Those high versus low on CL self were 2.25 times more likely to have undetectable viral load at baseline and 1.49 times more likely to maintain undetectable viral load over time. CL towards self predicted CD4 preservation after controlling for differences in CL giving. Conclusions. CL towards self is potentially the seed of being expressive and receptive of CL. Health care professionals prepared to walk the extra mile for those who neglect and isolate themselves may break a vicious circle since those lacking CL self were least likely to receive CL from others. Future studies should examine whether any enhancement of CL towards self may translate into slower disease progression and reduction of transmission risk.

The Association between Compassionate Love and Spiritual Coping with Trauma in Men and Women Living with HIV

“…In our previous study on CL, we found that high CL towards self had the strongest association with high CL receiving [4]. Participants with high CL towards self were also more likely to give CL to others.…”

“…In fact, only CL towards self but not other-centered CL, was associated with biological outcome [4]. In an additional study on PLWH [15], we have shown that the spiritual component of CL can also manifest through a view of God/Higher Presence as loving/benevolent.…”

“…As described in our previous study on CL [4], the most frequent criterion coded was free choice, followed by cognitive understanding, valuing/empowering, response of the heart and openness/receptivity for spirituality.…”

“…Underwood et al defined CL as "love that centers on the good of the other", which includes five criteria: free choice, cognitive understanding, valuing/empowering, openness, receptivity for spirituality, and response of the heart [3]. They also emphasize the dynamic process of CL: in order to give, one has to first be able to express CL towards self [4]. CL and spirituality/religion are oftentimes practiced together, as spiritual leaders and the exceptional individuals that are depicted in religious textbooks, emphasize the importance of unselfish attitude and love towards each other.…”

“…and receiving other-centered CL [4]. During inductive coding of the first cases, we added the concept of CL towards self to our structural framework.…”