Examining Predictors of Coping Strategies Among Women Living with HIV/AIDS in Bangladesh: Implications for Social Work Practice

Background/Objective

Healthy coping is essential in addressing HIV-related stigma (Kumar, Mohanraj, Rao, Murray, & Manhart, 2015). Nevertheless, the nature of HIV-related stigma (e.g., vicarious or enacted), affects women with HIV/AIDS in a number of ways including stress, anxiety, depression, and social isolation (Paudel & Baral, 2015; Julawong, 2009). Studies reported that positive attitudes toward HIV/AIDS enhance the ability of individuals to cope with their infections (Paudel & Baral, 2015). Therefore, healthy coping strategies are crucial to combat HIV-related stigma. Studies in developing countries showed that HIV-related stigma makes women living with HIV/AIDS (WLWHA) vulnerable to severe mental health problems (UNAIDS, 2017). Bangladesh is no difference since overwhelming gender inequality exacerbates WLWHA’s mental health. There is barely any study that explores how gender status affects women’s coping strategies in alleviating their HIV-related stigma in Bangladesh. This study delves into this issue.

Methods

This cross-sectional study was conducted among WLWHA (N=200) in Bangladesh. Two major organizations which provide direct services to the people living with HIV/AIDS were selected. WLWHA who expressed their interests in the study were screened against certain inclusion criteria (eighteen and above years old, could speak and understand Bengali and so forth). Apart from demographic information, standardized instruments including India HIV-related Stigma Scale (Steward, Herek, Ramakrishna, Bharat, Chandy, Wrubel, & Ekstrand, 2008), Social Support (Sherbourne & Stewart, 1991), Coping Self-Efficacy (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006), were utilized to collect the study data.

Results

Most of the participants were between 30 and 39 years old and a majority (60%) had secondary levels of education. The vast majority (87.5%) had a monthly income below US $ 62.5. For them, the levels of social support (r= .34, p <.001), self-esteem (r= -.21, p < .001), knowledge and attitudes (r= -.30, p < .001), and depression (r= -.40, p <.001) were associated with coping strategies. The results of the stepwise multiple regression analysis revealed two statistically significant predictors of coping strategies (=9.56, p <.001); With a β of -.31 (p <.05), levels of depression emerged as the strongest predictor of coping strategies indicating a negative partial correlation between depression and coping strategies. The second strongest predictor was social support, (β = .25, p <.05). This result indicated participants with higher levels of social support had higher levels of coping strategies.

Implications

The study findings are likely to add knowledge to social work education and research on coping strategies, depression, social support and mental health among WLWHA. Educational interventions and mental health services (e.g. counseling) might strengthen women’s coping with HIV in Bangladesh.